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Bill > HB840


MO HB840

MO HB840
Creates provisions relating to payments for prescription drugs


summary

Introduced
01/09/2025
In Committee
03/12/2025
Crossed Over
Passed
Dead
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)

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