HB1783 Summary

• Prohibits pharmacy benefit managers from restricting pharmacies and pharmacists from disclosing health information to customers, including treatment options, alternatives, authorization decisions, and financial incentive structures.

• Requires pharmacy benefit managers to allow customers to purchase prescriptions at the lower of their cost-sharing amount or the cash price, with amounts counting toward deductibles and out-of-pocket maximums.

• Establishes insurance commissioner enforcement authority to examine pharmacy benefit manager records, impose penalties up to an unspecified amount per violation, and suspend or revoke registrations for violations or non-compliance.

• Amends chapter 431S to require pharmacy benefit managers to register with the commissioner and submit application information including responsible individuals and agents for service of process, with registration and renewal fees to be determined.

• Modifies the definition of "covered entity" to include health insurers, mutual benefit societies, and HMOs under state regulation, removing employers and labor unions from the definition.