Bill > HB784

This bill creates new regulations for how health carriers and pharmacy benefits managers (PBMs) interact with covered entities that participate in the 340B drug-pricing program, which allows certain healthcare providers to purchase outpatient drugs at significantly reduced prices. The bill prohibits these health carriers and PBMs from discriminating against covered entities by implementing unfair practices such as reimbursing them at lower rates than other pharmacies, imposing different terms or conditions, requiring identification of 340B drugs, refusing to cover 340B drugs, or mandating unnecessary claim reversals. Specifically, the bill prevents PBMs from applying different professional dispensing fees, network participation requirements, audit standards, or other restrictive policies based on an entity's 340B status. The bill empowers the director of the department of commerce and insurance to impose civil penalties up to $5,000 per violation per day for non-compliance and requires the director to establish rules implementing these provisions. Covered entities include various healthcare organizations like hospitals, clinics, and their contracted pharmacies that qualify under federal guidelines for the 340B program.

Government Affairs, Health and Social Services

https://house.mo.gov/Bill.aspx?bill=HB784&year=2025&code=R