summary
Introduced
01/13/2026
01/13/2026
In Committee
01/13/2026
01/13/2026
Crossed Over
Passed
Dead
Introduced Session
126th General Assembly
Bill Summary
Amend The South Carolina Code Of Laws By Amending Section 40-43-60, Relating To Miscellaneous Requirements Concerning Pharmacies And The Practice Of Pharmacy, So As To Provide Pharmacies Permitted In This State Shall Cooperate With Federal And State Acquisition Cost Surveys; And By Adding Section 38-71-2270 So As To Provide Guidelines For Pharmacy Benefits Managers When Reimbursing Pharmacies And Pharmacists For Prescription Drugs And Pharmacy Services.
AI Summary
This bill amends South Carolina law to establish new requirements for pharmacies and Pharmacy Benefits Managers (PBMs) regarding drug acquisition cost surveys and reimbursement guidelines. Specifically, the bill requires pharmacies with state permits to cooperate with federal and state drug acquisition cost surveys, including the National Average Drug Acquisition Cost (NADAC) survey. For PBMs, the bill mandates that they cannot reimburse pharmacies for prescription drugs or services at an amount less than the NADAC plus a professional dispensing fee equivalent to the current South Carolina Medicaid rate. If NADAC is unavailable, PBMs must use the Wholesale Acquisition Cost (WAC) as an alternative pricing benchmark. The bill also creates a complaint mechanism through the Department of Insurance, allowing pharmacies to file claims if they are reimbursed below the minimum required amount. If a complaint is upheld, the PBM must pay the pharmacy twice the amount of the original underpayment and adjust reimbursement rates for similar pharmacies. The act will take effect upon the Governor's approval, providing a new framework to ensure fair drug reimbursement practices in the state.
Committee Categories
Business and Industry
Sponsors (24)
Heath Sessions (R)*,
Joe Bustos (R),
Heather Crawford (R),
Val Guest (R),
Tom Hartnett (R),
Lee Hewitt (R),
Harriet Holman (R),
Jermaine Johnson (D),
Jay Kilmartin (R),
Brian Lawson (R),
Ryan McCabe (R),
Cody Mitchell (R),
Dennis Moss (R),
Fawn Pedalino (R),
Tommy Pope (R),
Robby Robbins (R),
Carla Schuessler (R),
Bill Taylor (R),
David Vaughan (R),
Spencer Wetmore (D),
Joe White (R),
Mark Willis (R),
Chris Wooten (R),
Richie Yow (R),
Last Action
Member(s) request name added as sponsor: Crawford (on 03/04/2026)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.scstatehouse.gov/billsearch.php?billnumbers=4791&session=126&summary=B |
| Fiscal Note - H4791 2026-01-13 Introduced | https://www.scstatehouse.gov/sess126_2025-2026/fiscalimpactstatements/H4791%202026-01-13%20introduced.pdf |
| BillText | https://www.scstatehouse.gov/sess126_2025-2026/prever/4791_20251217.htm |
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