Bill > S2466

This bill requires pharmacy benefit managers (PBMs), which are companies that manage prescription drug benefits on behalf of health insurers, to provide fair reimbursement to pharmacies and pharmacists that are not affiliated with them. Specifically, PBMs cannot pay non-affiliated pharmacies less than they pay their own affiliated pharmacies for the same drug or service, considering all forms of payment and adjustments. The bill also prohibits PBMs from using contract terms, payment methods, or performance standards that result in lower reimbursement rates for non-affiliated pharmacies. To ensure compliance, PBMs must provide reimbursement data to the office of the health insurance commissioner (OHIC) upon request, and OHIC, along with the attorney general, will enforce these provisions. The bill also applies to Medicaid managed care organizations and their PBM contractors, preventing them from circumventing these rules through various arrangements. The OHIC is authorized to create regulations to implement and enforce this new section, which will take effect immediately upon passage.

Health and Social Services

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