Bill > HB192

This bill enacts the Community Pharmacy Protection Act, which introduces several key provisions aimed at regulating health plan issuers and pharmacy benefit managers (PBMs). The bill limits the accreditation requirements that health plan issuers can impose on pharmacies, ensuring that these requirements cannot be more stringent than those set by the state board of pharmacy. It also establishes a new reporting mechanism for PBMs, requiring them to submit quarterly electronic reports to the superintendent of insurance and contracted insurers, detailing drug claims processed in the previous quarter. These reports must include an itemized list of drug costs, specifying whether drugs are brand-name, generic, or specialty, and whether they were procured within or outside of the standard drug formulary. The bill prohibits PBMs from retaliating against pharmacies that report violations, such as terminating contracts without proper notice or subjecting pharmacies to increased audits without justification. If a health plan issuer or PBM violates these provisions, they may face administrative penalties of $1,000 per violation, with each day of continued violation considered a separate offense. The superintendent of insurance is empowered to investigate complaints, issue violation notices, and impose penalties, while also providing opportunities for hearings and appeals. Ultimately, the bill aims to increase transparency in drug pricing and protect community pharmacies from potentially unfair practices by health insurers and PBMs.

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https://www.legislature.ohio.gov/legislation/136/hb192