Bill > SB45

This bill enacts comprehensive provisions relating to prescription drug payments and pharmacy benefits management, focusing on protecting patients' rights and increasing transparency in the pharmaceutical industry. The bill introduces several key changes, including prohibiting pharmacy benefits managers (PBMs) from restricting patients' choice of pharmacies, requiring PBMs to provide clear information about drug costs, and establishing new definitions and standards for drug pricing and rebates. Specifically, the bill requires PBMs to notify health carriers of any conflicts of interest, defines terms like "generic drug" and "rebate" more precisely, and imposes a fiduciary duty on PBMs to act in the best interest of health benefit plan purchasers. The legislation also mandates that when calculating out-of-pocket maximums, health carriers must include amounts paid for medications without generic alternatives and prohibits varying cost-sharing requirements based on the availability of cost-assistance programs. Additionally, the bill establishes detailed appeals processes for pharmacies challenging maximum allowable cost pricing and ensures pharmacies are reimbursed fairly for prescription drugs, with provisions to protect patients' ability to receive pharmaceutical consultation and choose their preferred pharmacy.

Health and Social Services

https://www.senate.mo.gov/25info/BTS_Web/Bill.aspx?SessionType=R&BillID=209