Bill > LB198

This bill proposes significant changes to the Pharmacy Benefit Manager Licensure and Regulation Act, focusing on improving transparency, protecting consumer choice, and regulating pharmacy benefit managers (PBMs). The bill introduces new definitions for terms like clinician-administered drugs and specialty pharmacies, and establishes several key provisions: it prohibits PBMs from excluding Nebraska pharmacies from specialty pharmacy networks under certain conditions, restricts PBMs from imposing overly burdensome reporting requirements on specialty pharmacies, and prevents health benefit plans and PBMs from requiring patients to exclusively use mail-order pharmacies or PBM-affiliated pharmacies. The legislation also allows network pharmacies to decline providing a drug if they would be paid less than the acquisition cost, enables retail pharmacies to offer delivery services without network penalties, and mandates a phase-out of "spread pricing" - a practice where PBMs charge health plans more for medications than they reimburse pharmacies. Additionally, the bill provides specific guidelines for the shipment and administration of clinician-administered drugs, ensuring patient access and protecting healthcare providers. The changes are set to become operative on January 1, 2026, giving stakeholders time to adapt to the new regulations.

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https://nebraskalegislature.gov/bills/view_bill.php?DocumentID=59328