summary
Introduced
01/20/2025
01/20/2025
In Committee
02/14/2025
02/14/2025
Crossed Over
02/05/2025
02/05/2025
Passed
Dead
03/04/2025
03/04/2025
Introduced Session
2025 Regular Session
Bill Summary
An Act To Enact The Protecting Patient Access To Physician-administered Drugs Act; To State Legislative Intent; To Define Certain Terms; To Prohibit A Health Insurance Issuer, Pharmacy Benefit Manager Or The Agent Of Either From Refusing To Authorize, Approve Or Pay A Participating Provider For Providing Covered Physician-administered Drugs And Related Services To Covered Persons; To Prohibit A Health Insurance Issuer, Pharmacy Benefit Manager Or The Agent Of Either From Requiring A Covered Person To Pay Any Penalty Or Additional Fee Not Otherwise Applicable To Cost-sharing Amounts Payable By The Covered Person To Obtain The Physician-administered Drug When Provided By A Participating Provider; To Provide That All Provider Agreements Shall Be Construed To Include A Provision That, When All Criteria For Medical Necessity Are Met, The Drug And Its Administration Shall Be Payable Irrespective Of Whether The Participating Provider Obtains Physician-administered Drugs From A Pharmacy That Is Not A Participating Provider In The Health Insurance Issuer's Network; To Provide Payment Rates To Participating Providers; To Provide That Contract Provisions In Conflict With This Act Shall Be Null, Void And Unenforceable; To Provide That A Violation Of This Act Shall Be Considered A Violation Of The Consumer Protection Act, And Shall Subject The Violator To Any And All Actions Provided For In The Consumer Protection Act; To Amend Section 75-24-5, Mississippi Code Of 1972, To Conform To The Provisions Of This Act; And For Related Purposes.
AI Summary
This bill, known as the Protecting Patient Access to Physician-Administered Drugs Act, aims to safeguard patients' access to physician-administered drugs and related services by imposing new requirements on health insurance issuers and pharmacy benefit managers. The bill defines key terms such as "covered person" (an individual covered by a health insurance plan), "participating provider" (a licensed healthcare professional who has an agreement with a health insurance issuer), and "physician-administered drug" (a prescription drug requiring administration by a provider). It prohibits health insurance issuers and pharmacy benefit managers from refusing to authorize or pay for covered drugs and services, and from imposing additional fees on patients when receiving these drugs from a participating provider. The bill mandates that provider agreements must cover physician-administered drugs when medical necessity criteria are met, regardless of whether the drugs are obtained from a network pharmacy. Furthermore, the bill establishes that payment to participating providers will be at the rate specified in their agreement or at the wholesale acquisition cost. Any contract provisions conflicting with this act will be considered null and void, and violations will be treated as violations of the Consumer Protection Act, subjecting offenders to potential investigations and penalties. The bill also amends the existing Consumer Protection Act to include violations of this new law as an unfair trade practice.
Committee Categories
Business and Industry, Health and Social Services
Sponsors (1)
Last Action
Died In Committee (on 03/04/2025)
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://billstatus.ls.state.ms.us/2025/pdf/history/SB/SB2712.xml |
| BillText | https://billstatus.ls.state.ms.us/documents/2025/html/SB/2700-2799/SB2712PS.htm |
| BillText | https://billstatus.ls.state.ms.us/documents/2025/html/SB/2700-2799/SB2712IN.htm |
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