Bill > LB324

This bill, the Pharmacy Benefit Fairness and Transparency Act, aims to regulate pharmacy benefit managers (PBMs) in Nebraska. The key provisions include: 1. Requiring PBMs to obtain a certificate of authority as a third-party administrator and comply with the Third-Party Administrator Act and this new Act. 2. Mandating PBMs to exercise good faith and fair dealing in their contracts with covered entities (e.g., insurers) and pharmacies. 3. Prohibiting PBMs from imposing overly stringent record-keeping requirements on pharmacies, discriminating against in-state pharmacies, and forcing pharmacies to participate in multiple PBM contracts. 4. Requiring PBMs to disclose their pricing methodologies, reimbursement amounts, and financial benefits received from manufacturers to covered entities. 5. Establishing timely payment requirements for clean claims submitted by pharmacies and an appeals process for audits conducted by PBMs. 6. Allowing pharmacists to share information about drug costs and copayments with patients, and prohibiting PBMs from penalizing them for doing so. 7. Requiring covered entities to notify the Department of Insurance of any detected fraud or prescription drug diversion activity. The overall goal is to increase transparency and fairness in the pharmacy benefits management industry, protecting both pharmacies and consumers.

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https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=30855