Bill > S1389

This bill amends existing law to establish provisions governing pharmacy benefit managers (PBMs). It defines key terms such as "brand name or generic effective rate," "dispensing fee," "maximum allowable cost," and "pharmacy benefit manager." The bill requires PBMs to be registered with the Department of Insurance, prohibits them from prohibiting pharmacists from providing information to patients about costs and alternative drugs, and mandates the pass-through of 100% of manufacturer rebates to the pharmacy benefits plan or program. The bill also sets requirements for PBM contracts, including the use of a pass-through pricing model, prohibition of spread pricing, and network adequacy standards. Additionally, it establishes an administrative appeal process for pharmacies to challenge maximum allowable cost pricing and reimbursement, and prohibits PBMs from engaging in certain practices that could disadvantage pharmacies.

Health and Social Services, Justice

State Affairs Committee (Senate)

https://legislature.idaho.gov/sessioninfo/2024/legislation/S1389/