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IA SF383
Bill
Status
6/11/2025
Primary Sponsor
Health And Human Services
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AI Summary
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Requires pharmacy benefits managers (PBMs) to reimburse retail pharmacies at no less than the national average drug acquisition cost plus a $10.68 professional dispensing fee, and prohibits PBMs from reimbursing in-state pharmacies less than their affiliates receive for the same drugs
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Prohibits PBMs, health carriers, and third-party payors from discriminating against pharmacies or pharmacists, limiting patient pharmacy choice, requiring exclusive mail-order pharmacy use, or imposing more restrictive conditions on retail pharmacies compared to mail-order services
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Mandates 100% of prescription drug rebates received by PBMs be passed through to health carriers or employee plan sponsors, and requires any patient payments count toward their cost-sharing and deductibles
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Requires PBMs to use pass-through pricing in contracts executed or renewed after July 1, 2025, ensuring payments from third-party payors equal what PBMs pay to dispensing pharmacies
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Directs the Insurance Commissioner to submit a report by January 1, 2026, analyzing pharmacy services administrative organizations, the prescription drug wholesale supply chain, and market concentration in drug distribution
Legislative Description
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.
Last Action
Signed by Governor. S.J. 1054.
6/11/2025