Bill > HF2401

This bill amends the existing law to regulate pharmacy benefits managers (PBMs) in several key ways: 1. It defines "pass-through pricing" and "spread pricing" models for PBMs, prohibiting the use of spread pricing unless the difference is passed through to the third-party payor. 2. It prohibits discrimination by PBMs, health carriers, or third-party payors against pharmacies or pharmacists acting within their scope of practice. 3. It requires all PBM contracts with third-party payors to use pass-through pricing, unless the spread pricing difference is passed through to the payor. 4. It establishes an appeals process for pharmacies to challenge PBM maximum allowable costs or reimbursement rates that are below the pharmacy's acquisition cost. 5. It directs the state to procure a technology platform and related services to conduct reverse auctions for PBM services for state-funded and certain private-sector health plans. This is intended to promote competition and transparency in PBM pricing.