Bill > SB2007

This bill requires Pharmacy Benefit Managers (PBMs), which are companies that manage prescription drug benefits on behalf of health insurers, to remit administrative fees to providers, such as pharmacies, under specific circumstances. If a PBM increases a provider's reimbursement for a drug, medical product, or device due to an appeal, and then reduces that reimbursement for the same item within thirty days, the PBM must pay the provider a fee of at least $100. This fee increases to at least $500 if not paid within ninety days, and to at least $1,000 if not paid within 180 days. The bill also updates existing language regarding PBM contractual duties to providers, including how they determine Maximum Allowable Cost (MAC) pricing, handle appeals, and provide information about drug availability and pricing. The bill will become effective on November 1, 2026.