Bill > LD1580

This bill prohibits carriers (health insurance companies) and pharmacy benefits managers (PBMs) from using spread pricing, which is a practice where these entities charge health plans more for prescription drugs than they pay pharmacies, effectively pocketing the difference. The bill defines spread pricing as any amount charged by a PBM that exceeds the actual ingredient cost of a prescription drug plus the pharmacy's dispensing fee. Under this legislation, carriers and PBMs are prohibited from engaging in spread pricing either directly or through intermediaries, and they must annually certify their compliance to the state superintendent, with the certification signed by their chief executive or financial officer. Beginning January 1, 2026, carriers and PBMs will be subject to this requirement, and the law includes a penalty mechanism for non-compliance. The bill specifically exempts the MaineCare program and includes a sunset provision that will automatically repeal the section on January 1, 2031. The law will apply to contracts entered into or renewed on or after January 1, 2026, giving businesses time to adjust their practices to comply with the new requirements.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=1580&snum=132