Bill > SSB1207

Introduced Session

This bill relates to pharmacy benefits managers, pharmacies, and prescription drugs. Under the bill, except for specialty drugs, a pharmacy benefits manager (PBM) shall not require a covered person, as a condition of payment or reimbursement, to purchase S.F. _____ pharmacy services, exclusively through a mail order pharmacy. “Specialty drug” is defined in the bill. Under the bill, 100 percent of all rebates received by a PBM shall be passed through to the health carrier or employer plan sponsor to reduce premiums. “Pass-through pricing” is defined in the bill. Under the bill, for a prescription filled at a pharmacy with five or less locations, a PBM shall reimburse the pharmacy or pharmacist a $3 professional dispensing fee. For a prescription filled at a pharmacy with six or more locations, and that has any location located in a pharmacy desert, a PBM shall reimburse the pharmacy in the pharmacy desert a professional dispensing fee of $3. “Pharmacy desert” is defined in the bill. Under the bill, all contracts executed, amended, adjusted, or renewed on or after July 1, 2025, that apply to prescription drug benefits on or after January 1, 2026, between a PBM and a third-party payor, or between a person and a third-party payor, shall prohibit the practice of spread pricing. “Spread pricing” is defined in the bill.

Committee Categories

No sponsors listed

Other Sponsors (1)

Subcommittee recommends amendment and passage. (on 03/06/2025)

Official Document