Bill > SB13

This bill establishes new provisions in Missouri law regarding insurance coverage of pharmacy and drug services, focusing on three key areas: clinician-administered drugs, biosimilar products, and 340B drug pricing. First, the bill prohibits health carriers and pharmacy benefits managers from penalizing healthcare providers, pharmacies, or patients for obtaining or administering medically necessary clinician-administered drugs, regardless of whether the drug source is within the insurance network. Second, the bill requires health carriers to provide consistent coverage for reference biological products and their biosimilar alternatives, ensuring equal scope, extent, and cost-sharing for these medications. Third, the bill prevents health carriers and pharmacy benefits managers from discriminating against covered entities and pharmacies participating in the 340B drug pricing program, which helps certain healthcare organizations access discounted medications. The bill prohibits practices such as lower reimbursement rates, unequal contract terms, interference with patient choice, and mandatory drug identification beyond 45 days after sale. The Missouri Department of Commerce and Insurance is authorized to impose civil penalties up to $5,000 per violation per day for non-compliance and must develop rules to implement these provisions. The bill aims to protect healthcare providers, patients, and pharmacies from potentially unfair practices in drug pricing and insurance coverage.

Health and Social Services

https://www.senate.mo.gov/25info/BTS_Web/Bill.aspx?SessionType=R&BillID=311