HB345 Summary

• Prohibits pharmacy benefits managers (PBMs) from steering patients to affiliated pharmacies through ordering, plan designs, or marketing, though affiliated pharmacies may be included in general network communications with full disclosure of non-affiliated options.

• Prohibits PBMs from transferring or sharing patient prescription data with affiliated pharmacies for commercial purposes, except for limited operational purposes like pharmacy reimbursement and utilization review.

• Prohibits health benefit plans from requiring enrollees to use mail-order or affiliated pharmacies exclusively and prohibits imposing different co-payments or conditions on patients choosing other providers if those providers accept the same terms.

• Requires PBMs to report annually to clients the aggregate amount of pharmaceutical manufacturer rebates received and the aggregate amount of rebates not passed through to clients.

• Establishes civil penalties up to $5,000 per violation enforced by the Department of Insurance Commissioner, with authority to impose injunctive relief, restitution, and license suspension or revocation for repeated violations.