CA SB966

Requires pharmacy benefit managers (PBMs) to apply for a license from the Department of Insurance by January 1, 2027, and establishes application qualifications, initial fees of $11,160, and renewal fees of $10,120 every two years.

Prohibits health care service plans and health insurers from calculating enrollee or insured cost sharing for prescription drugs at amounts exceeding the actual rate paid for the drug, effective January 1, 2025.

Requires PBMs to file annual reports disclosing drug pricing, rebate information, revenue sources, and group purchasing organization relationships, with aggregated public reports published by the Department of Insurance.

Establishes duties and prohibitions for PBMs including prohibiting discrimination against nonaffiliated pharmacies, restricting retroactive claim denials, requiring full rebate pass-through to health plans, and prohibiting exclusivity arrangements with manufacturers and pharmacies effective January 1, 2025.

Creates civil penalties of $1,000 to $7,500 per violation and authorizes the Attorney General to pursue injunctive relief; establishes the Pharmacy Benefit Manager Account in the Insurance Fund and the Pharmacy Benefit Manager Fines and Penalties Account in the General Fund.