summary
Introduced
01/09/2025
01/09/2025
In Committee
03/12/2025
03/12/2025
Crossed Over
Passed
Dead
05/16/2025
05/16/2025
Introduced Session
2025 Regular Session
Bill Summary
Creates provisions relating to payments for prescription drugs
AI Summary
This bill creates new provisions relating to prescription drug payments and pharmacy benefits managers (PBMs), with several key changes. The legislation aims to protect patients' and pharmacies' rights by preventing PBMs from restricting prescription drug access, mandating transparency in drug pricing, and establishing fiduciary duties for PBMs. Specifically, the bill prohibits PBMs from charging excessive fees, redirecting patients from their preferred pharmacy, or penalizing pharmacies for providing services. It requires PBMs to disclose potential conflicts of interest to health benefit plan sponsors, defines terms like "rebate" and "generic drug" more precisely, and establishes an appeals process for pharmacies challenging drug reimbursement rates. The bill also introduces new rules for calculating out-of-pocket costs, requiring health carriers to include amounts paid for medications without generic alternatives when determining cost-sharing maximums. Additionally, the legislation prevents health carriers from varying out-of-pocket maximums based on the availability of cost-sharing assistance programs for specific medications. These provisions are designed to increase transparency, protect patient choice, and ensure fair compensation for pharmacies in prescription drug transactions.
Committee Categories
Health and Social Services
Sponsors (1)
Last Action
Rules - Administrative Executive Session (09:30:00 4/8/2025 House Hearing Room 4) (on 04/08/2025)
Official Document
bill text
bill summary
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bill summary
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bill summary
Document Type | Source Location |
---|---|
State Bill Page | https://house.mo.gov/Bill.aspx?bill=HB840&year=2025&code=R |
Fiscal Note - 2109H.01I.ORG | https://documents.house.mo.gov/billtracking/bills251/fiscal/fispdf/2109H.01I.ORG.pdf |
Analysis - Summary: Introduced | https://documents.house.mo.gov/billtracking/bills251/sumpdf/HB0840I.pdf |
BillText | https://documents.house.mo.gov/billtracking/bills251/hlrbillspdf/2109H.01I.pdf |
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