| 39 | | - | [ prescription drugs - reports - requirements - rules |
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| 40 | | - | - codification - effective date ] |
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| 63 | + | AS INTRODUCED |
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| 64 | + | |
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| 65 | + | An Act relating to prescription drugs; defining |
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| 66 | + | terms; requiring certain repo rt be compiled by the |
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| 67 | + | Insurance Department by certain date; requiring |
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| 68 | + | certain reports be submitted by certain drug |
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| 69 | + | manufacturer by certain date; requiring certain |
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| 70 | + | report be submitted by certain phar macy benefits |
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| 71 | + | manager; directing Department to publish certain |
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| 72 | + | information on certain website; establishing data |
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| 73 | + | requirements for publishing and physical component; |
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| 74 | + | directing Department to promulgate rules; providing |
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| 75 | + | for codification; and providing an effective date . |
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| 76 | + | |
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| 41 | 77 | | |
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| 42 | 78 | | |
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| 43 | 79 | | |
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| 44 | 80 | | |
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| 45 | 81 | | BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: |
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| 46 | 82 | | SECTION 1. NEW LAW A new section of law to be codified |
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| 47 | 83 | | in the Oklahoma Statutes as Section 6970 of Title 36, unless there |
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| 48 | 84 | | is created a duplication in numb ering, reads as follows: |
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| 49 | 85 | | A. As used in this section: |
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| 50 | 86 | | 1. “Manufacturer” means any person or entity that holds the |
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| 51 | 87 | | national drug code for a prescription drug and is engaged in the |
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| 52 | 88 | | production, preparation, propagation, compounding, c onversion, or |
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| 53 | 89 | | processing of drug pro ducts for treating diabetes in this state; |
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| 88 | 148 | | 1. A list of prescription drugs that the Depar tment determines |
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| 89 | 149 | | to be essential for treating di abetes in this state and the |
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| 90 | 150 | | wholesale acquisition cost of each drug on the list. The list shall |
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| 91 | 151 | | include, but not be limited to, all form s of insulin and biguanides |
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| 92 | 152 | | marketed for sale in this state ; and |
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| 93 | 153 | | 2. A list of prescription drugs described in paragraph 1 of |
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| 94 | 154 | | this subsection that have been subject to an increase in the |
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| 95 | 155 | | wholesale acquisition cost of a percentage equal to or greater than: |
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| 96 | 156 | | a. the percentage increase in the medical care index of |
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| 97 | 157 | | the Consumer Price Index, during the immediately |
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| 98 | 158 | | preceding year, or |
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| 99 | 159 | | b. twice the percentage increase in the medical care |
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| 100 | 160 | | index of the Consumer Price Index, during the |
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| 101 | 161 | | immediately preceding two calenda r years. |
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| 102 | 162 | | C. On or before April 1 of each cal endar year, the manufacturer |
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| 103 | 163 | | of a prescription drug that appears on the most current list |
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| 104 | 164 | | compiled by the Department pursuant to subsection A of this section |
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| 139 | 223 | | period during which the manufacturer has marketed the drug for sale |
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| 140 | 224 | | that is attributable to the drug; |
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| 141 | 225 | | 4. The total amount of financial assistance that the |
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| 142 | 226 | | manufacturer has provided through any patient prescription |
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| 143 | 227 | | assistance program; |
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| 144 | 228 | | 5. The cost associated wi th coupons provided dire ctly to |
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| 145 | 229 | | consumers and for programs to assist consumers in paying copayments, |
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| 146 | 230 | | and the cost to the manufacturer attributable to the redem ption of |
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| 147 | 231 | | those coupons and the use of thos e programs; |
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| 148 | 232 | | 6. The wholesale acquisition cost of the drug; |
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| 149 | 233 | | 7. A history of any increases in the wholesale acquisition cost |
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| 150 | 234 | | of the drug over the five (5) yea rs immediately preceding the date |
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| 151 | 235 | | on which the report is subm itted, including the amount of each |
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| 152 | 236 | | increase expressed as a percentage of the total wholesa le |
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| 153 | 237 | | acquisition cost of the drug, the month and year in which each |
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| 154 | 238 | | increase became effective, and any explanation f or the increase; |
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| 189 | 297 | | D. On or before April 1 of a year in which a drug is included |
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| 190 | 298 | | on the list compiled pu rsuant to subsection B of this section, the |
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| 191 | 299 | | manufacturer of the drug shall submit to the Dep artment a report |
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| 192 | 300 | | describing the reasons for the increase in the wholesale acquisi tion |
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| 193 | 301 | | cost of the drug described in that subsection. The report shall |
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| 194 | 302 | | include, but not be limited to: |
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| 195 | 303 | | 1. A list of each factor that has cont ributed to the increase; |
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| 196 | 304 | | 2. The percentage of the total increase that is attributable to |
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| 197 | 305 | | each factor; |
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| 198 | 306 | | 3. An explanation o f the role of each factor in the increase; |
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| 199 | 307 | | and |
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| 200 | 308 | | 4. Any other information prescribed by rule of the Department. |
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| 201 | 309 | | E. Except as provided in this section, a pharmacy benefits |
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| 202 | 310 | | manager shall submit to the Department a report that shall include: |
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| 203 | 311 | | 1. The total amount of all rebate s that the pharmacy benefits |
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| 204 | 312 | | manager negotiated with the manufacturers during the immediately |
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| 205 | | - | preceding calendar yea r for prescription drugs included on the list |
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| 206 | | - | compiled by the Department pursuant to subsection B of this section; |
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| 207 | | - | 2. The total amount of all rebates described in paragraph 1 of |
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| 208 | | - | this subsection that were ret ained by the pharmacy benefits manager; |
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| 209 | | - | 3. The total amount of all rebates described in paragraph 1 of |
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| 210 | | - | this subsection that the pharmacy benefits manager negotiated for |
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| 211 | | - | purchases of drugs for use by: |
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| 212 | | - | a. recipients of Medicare, |
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| 364 | + | preceding calendar yea r for prescription drugs included on the list |
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| 365 | + | compiled by the Department pursuant to subsection B of this section; |
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| 366 | + | 2. The total amount of all rebates described in paragraph 1 of |
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| 367 | + | this subsection that were ret ained by the pharmacy benefits manger; |
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| 368 | + | 3. The total amount of all rebates described in paragraph 1 of |
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| 369 | + | this subsection that the pharmacy benefits manager negotiated for |
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| 370 | + | purchases of drugs for use by: |
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| 371 | + | a. recipients of Medicare, |
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| 240 | 372 | | b. recipients of Medicai d, |
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| 241 | 373 | | c. persons covered by third parties that are gover nmental |
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| 242 | 374 | | entities not described in subparagraphs a and b of |
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| 243 | 375 | | this paragraph, |
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| 244 | 376 | | d. persons covered by third parties that are not |
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| 245 | 377 | | governmental entities, and |
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| 246 | 378 | | e. persons covered by a plan described in paragraph 4 of |
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| 247 | 379 | | this subsection to the extent required by a contract |
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| 248 | 380 | | entered into pursuant to paragraph 5 of this |
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| 249 | 381 | | subsection; |
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| 250 | 382 | | 4. Except as otherwise provi ded in subparagraph c of paragraph |
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| 251 | 383 | | 3 of this subsection, the requirements of this section do not apply |
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| 252 | 384 | | to the coverage of pres cription drugs under a plan that is subject |
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| 253 | 385 | | to the federal Employee Retirement Income Security Act of 1974 as |
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| 254 | 386 | | amended or any information relating to that co verage; and |
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| 255 | | - | 5. A plan described in paragraph 4 of this subsection may, by |
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| 256 | | - | contract, require a pharmacy bene fits manager that manages the |
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| 257 | | - | coverage of prescription drugs under the plan to comply with the |
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| 258 | | - | requirements of this section. |
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| 259 | | - | F. The Department shall ana lyze the information submitted |
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| 260 | | - | pursuant to subsections C, D, and E of this section and publish a |
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| 261 | | - | report on the website created under s ubsection G of this section on |
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| 262 | | - | the price of the prescription drugs that appear on the most current |
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| 263 | | - | lists compiled by the Department pursuant to subsection B of this |
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| 438 | + | 5. A plan described in paragraph 4 of this subsection may, by |
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| 439 | + | contract, require a pharmacy bene fits manager that manages the |
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| 440 | + | coverage of prescription drugs under the plan to comply with the |
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| 441 | + | requirements of this section. |
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| 442 | + | F. The Department shall ana lyze the information submitted |
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| 443 | + | pursuant to subsections C, D, and E of this section and publish a |
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| 444 | + | report on the website created under s ubsection G of this section on |
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| 445 | + | the price of the pre scription drugs that appear on the most current |
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| 446 | + | lists compiled by the Department pursuant to subsection B of this |
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| 291 | 447 | | section, the reasons for any increases in those prices, and the |
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| 292 | 448 | | effect of those prices on o verall spending on prescription drugs in |
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| 293 | 449 | | this state. The report may include , but not be limited to, |
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| 294 | 450 | | opportunities for persons and entities in this state to lower the |
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| 295 | 451 | | cost of drugs for the treatment of diab etes while maintaining access |
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| 296 | 452 | | to the drugs. |
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| 297 | 453 | | G. 1. The Department shall create and maintain a websit e, to |
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| 298 | 454 | | be updated no less frequently than once each calendar quarter, and |
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| 299 | 455 | | shall place or cause t o be placed: |
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| 300 | 456 | | a. the list of prescription drugs compi led by the |
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| 301 | 457 | | Department pursuant to subsection B of this section, |
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| 302 | 458 | | b. the wholesale acquisition cost of eac h prescription |
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| 303 | 459 | | drug reported pursuant to subsection C of this |
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| 304 | 460 | | section, and |
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| 305 | | - | c. the reports compiled b y the Department pursuant to |
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| 306 | | - | subsection F of this subsectio n. |
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| 307 | | - | 2. The Department shall ensure that the informa tion placed on |
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| 308 | | - | the website is organized so that each individual manufacturer has |
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| 309 | | - | its own separate entry on the webs ite. |
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| 310 | | - | 3. The Department may es tablish additional or alt ernative |
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| 311 | | - | procedures by which a con sumer who is unable to access the Internet |
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| 312 | | - | or is otherwise unable to receive the information described in this |
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| 313 | | - | section may access this data. This shall include, but not be |
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| 512 | + | c. the reports compiled b y the Department pursuant to |
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| 513 | + | subsection F of this subsectio n. |
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| 514 | + | 2. The Department shall ensure that the informa tion placed on |
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| 515 | + | the website is organized so that eac h individual manufacturer has |
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| 516 | + | its own separate entry on the webs ite. |
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| 517 | + | 3. The Department may es tablish additional or alt ernative |
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| 518 | + | procedures by which a con sumer who is unable to access the Internet |
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| 519 | + | or is otherwise unable to receive the information described in this |
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| 520 | + | section may access this data. This shall include, but not be |
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