SB236 Summary

• Prohibits pharmacy benefits managers from steering patients to affiliated pharmacies through ordering patients to affiliated pharmacies, offering plan designs requiring affiliated pharmacies, or advertising/marketing affiliated pharmacies.

• Prohibits pharmacy benefits managers from transferring or sharing patient prescription data with affiliated pharmacies for commercial purposes, except for limited purposes of pharmacy reimbursement, formulary compliance, pharmacy care, or utilization review.

• Prohibits health benefit plans from requiring covered persons to obtain prescription drugs exclusively from mail-order distributors or affiliated pharmacies, and requires equal co-payments and conditions for non-affiliated pharmacy providers.

• Requires pharmacy benefits managers to report annually to clients the aggregate amount of rebates received from pharmaceutical manufacturers and the amount of rebates not passed through to clients.

• Establishes civil penalties up to $5,000 per violation, with enforcement by the Insurance Commissioner through complaints, investigations, and remedies including injunctive relief, restitution, and license suspension or revocation.