Bill > HB226

This bill: - Requires pharmacy benefits managers (PBMs) to register with the state's insurance division, rather than just being licensed as third-party administrators. PBMs must follow procedures for licensure, hearings, and penalties like other insurance entities. - Establishes a duty of care for PBMs to act in the best interests of plan sponsors, benefits administrators, and covered persons. This includes disclosing conflicts of interest, passing through all payments or benefits received from drug manufacturers, and providing detailed information on drug costs and pricing. - Regulates how PBMs set and maintain their lists of covered drugs, including requirements around therapeutic and pharmaceutical equivalence, availability, and transparency. - Prohibits insurers and PBMs from certain practices that could restrict a patient's access to clinician-administered drugs or choice of pharmacy. - Allows the insurance division to adopt regulations on PBM claims processing, grievances, independent review, and appeals. - Defines key terms related to PBMs, pharmacies, drugs, and insurance. The bill aims to increase transparency and regulate the business practices of pharmacy benefits managers to protect consumers and ensure they have access to affordable prescription drugs.

Business and Industry, Health and Social Services

https://www.akleg.gov/basis/Bill/Detail/33?Root=HB226