Bill > SB389

This bill requires the Nevada Department of Health and Human Services to select and contract with a single state pharmacy benefit manager (PBM) to manage pharmacy benefits for Medicaid and certain other health plans by January 1, 2030. The state PBM will be responsible for negotiating drug prices, establishing reimbursement methodologies for pharmacies, and managing prescription drug coverage. The bill includes several key provisions to increase transparency and control costs, such as requiring the PBM to disclose financial information, prohibiting spread pricing, and establishing a Nevada Average Acquisition Cost benchmark to measure drug pricing. Medicaid managed care organizations will be required to work with the state PBM and use its pharmacy benefit management services. The bill also places restrictions on the state PBM, including preventing them from discriminating against certain pharmacies, creating unauthorized fees, or requiring patients to use specific pharmacies. Additionally, the Department must conduct regular audits of the PBM and submit biennial reports to the Legislature about the cost savings achieved through these new pharmacy benefit management practices. The goal is to improve transparency, reduce prescription drug costs, and create more efficient pharmacy benefit management for state health programs.

Budget and Finance, Business and Industry, Health and Social Services

https://www.leg.state.nv.us/App/NELIS/REL/83rd2025/Bill/12689/Overview