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GA HB1026

Bill

Status

Introduced

2/18/2014

Primary Sponsor

Benjie Harbin

Click for details

Origin

House of Representatives

2013-2014 Regular Session

AI Summary

  • Adds new definitions to Georgia's pharmacy benefits manager (PBM) law, including "health system," "in-person pharmacy," "maximum allowable cost," and "pharmacy"
  • Requires PBMs using maximum allowable cost (MAC) pricing to disclose their methodology and sources in contracts, update pricing information to pharmacies every 7 calendar days, and notify covered entities of material changes within 15 days
  • Establishes criteria for drugs placed on MAC lists, including requiring at least 3 nationally available therapeutically equivalent sources, a minimum 10% cost difference between manufacturers, FDA "A" rating, and availability from licensed wholesalers without a 14-day or longer period of unavailability
  • Prohibits PBMs and insurers from imposing different copayments, deductibles, fees, or benefit limitations on covered individuals who use in-person pharmacies versus mail service pharmacies, provided the in-person pharmacy accepts the same pricing terms as the mail service pharmacy
  • Extends the Pharmacy Audit Bill of Rights to apply to entities licensed by the Commissioner of Insurance and grants the Commissioner enforcement authority over audits conducted by such licensed entities

Legislative Description

Pharmacy benefits managers; regulation and licensure; define certain terms; provisions

Last Action

House Second Readers

2/20/2014

Full Bill Text

No bill text available