Bill > H1082

This bill enacts the Pharmacy Benefit Manager (PBM) Compensation Reform Act of 2022, establishing comprehensive regulations for how pharmacy benefit managers operate in the state. The legislation aims to increase transparency and fairness in prescription drug pricing by prohibiting spread pricing, where PBMs charge health plans more for prescription drugs than they pay pharmacies. The bill requires PBMs to derive income only from a clearly defined pharmacy benefit management fee, which cannot be based on drug acquisition costs, rebates, or other contingent factors. PBMs must annually certify their compliance with these rules to the insurance commissioner, and they are subject to annual audits that can review detailed claims data, reimbursement information, and rebate amounts. The bill mandates that PBM contracts with carriers or health benefit plans must specify all forms of revenue and explicitly acknowledge the prohibition on spread pricing. Additionally, the legislation provides penalties for non-compliance, giving the insurance commissioner the authority to issue monetary penalties, suspend or revoke a PBM's license, or take other necessary actions. The bill also includes confidentiality protections for sensitive financial and competitive information revealed during audits, ensuring that trade secrets are not publicly disclosed.

Business and Industry, Health and Social Services

https://malegislature.gov/Bills/194/H1082