Bill > HB690

This bill amends Georgia's pharmacy benefits manager (PBM) regulations by establishing a comprehensive set of duties and responsibilities for PBMs. The bill expands the definitions of key terms related to pharmacy benefits management and introduces a new legal framework that requires PBMs to operate with care, skill, transparency, and professionalism when serving insureds, health plans, and providers. Specifically, the bill creates a legal duty for PBMs to act in the best interests of insureds, with a priority placed on the insured's interests over other parties. The legislation introduces new definitions for terms like "controlled group of corporations," "spread pricing," and "pharmacy benefits manager duty," and requires PBMs to disclose conflicts of interest and provide transparency about their pricing and services. The bill also establishes a private right of action, allowing individuals who are aggrieved by a PBM's violation of these duties to file a civil lawsuit. Additionally, the bill clarifies that federal law will take precedence if there are conflicts with state regulations and empowers the state insurance commissioner to adopt specific regulations defining the scope of PBM duties to different stakeholders.

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https://www.legis.ga.gov/legislation/71025