Bill > LB109

This bill establishes new regulations for insurance policies, health plans, and pharmacy benefit managers (PBMs) regarding clinician-administered drugs, focusing on protecting patients' rights and increasing healthcare provider flexibility. The bill defines clinician-administered drugs as outpatient prescription drugs that cannot be reasonably self-administered and are typically given by a healthcare professional in clinical settings. Specifically, the bill prohibits insurers and PBMs from: refusing to authorize or pay for clinician-administered drugs, imposing additional fees or penalties when patients obtain these drugs from authorized providers, interfering with patient choice of drug source, requiring drugs to be dispensed only by insurer-selected pharmacies, or penalizing healthcare providers for obtaining drugs from non-network sources. Additionally, the bill mandates that PBMs cannot restrict how pharmacies deliver prescription drugs, require pharmacies to participate in mail-order contracts, or exclude accredited specialty pharmacies from their networks with unreasonable terms. These provisions aim to increase patient access to necessary medications, reduce administrative barriers, and provide more transparency and flexibility in healthcare drug procurement and administration.

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https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=58944