Bill > SB478

This bill aims to strengthen prescription drug affordability and pharmacy benefits manager (PBM) accountability in New Hampshire by introducing comprehensive regulations. The legislation establishes new rules for PBMs, including prohibiting income derived from services except through clearly defined management fees, banning fees based on drug prices or savings, and requiring annual certification of compliance. The bill mandates that PBMs cannot assess retroactive fees on clean claims, must provide timely access to pricing lists, and cannot discriminate against 340B covered entities. It also introduces patient protections such as electronic prior authorization, clear formulary exception processes, and a cap on insulin cost-sharing. PBMs will be required to submit annual confidential reports to the New Hampshire Insurance Department detailing rebates and administrative fees, with public aggregated data to be published. Additionally, the bill introduces a duty of care for PBMs, requiring them to act in the best interests of enrollees, health plans, and providers, with transparency and professionalism. The legislation aims to reduce drug costs, increase transparency, and align incentives among manufacturers, PBMs, health carriers, pharmacies, hospitals, and patients, with most provisions taking effect on January 1, 2027.