Bill > H4794

This bill amends South Carolina law to regulate pharmacy benefits managers (PBMs) by introducing new definitions and prohibiting several unfair trade practices. The bill defines "spread pricing" as a pricing model where PBMs charge health plans a different price for prescription drugs than what they pay pharmacies, and expands the definition of "specialized delivery drug" to include medications that require special handling, complex patient education, or treat chronic, complex, or rare medical conditions. The legislation prohibits PBMs from engaging in numerous problematic practices, including patient steering, selling patient information, retroactively denying pharmacy claims, reimbursing local pharmacies less than chain pharmacies, exploiting prescription drug information, and operating without proper state registration. Additionally, the bill requires that an enrollee's cost-sharing for prescription drugs be calculated using a price reduced by at least 100% of all rebates received, and mandates transparency by requiring PBMs to provide a transactional history of rebates. Violations of these provisions are considered unfair trade practices, and each violation can be treated as a separate offense. The bill aims to increase transparency, protect patients and pharmacies, and prevent PBMs from engaging in potentially predatory business practices. The legislation will take effect upon the Governor's approval.

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https://www.scstatehouse.gov/billsearch.php?billnumbers=4794&session=126&summary=B