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IN HB1214
Bill
Status
1/13/2015
Primary Sponsor
Steven Davisson
Click for details
AI Summary
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Establishes fiduciary duties for pharmacy benefits managers (PBMs) to covered entities including insurers, health maintenance organizations, state health programs, and self-funded plans, effective July 1, 2015.
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Requires PBMs to disclose conflicts of interest, provide financial and utilization information, and transfer to covered entities any benefits or payments derived from drug substitutions or volume-based sales incentives.
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Mandates PBMs provide pharmacies with market-based pricing sources at the start of each calendar year and updated prices at least every 7 days, with an administrative appeals process requiring response within 7 days.
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Restricts placement of drugs on maximum allowable cost price lists unless at least 3 therapeutically equivalent generic alternatives are nationally available with significant cost differences.
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Establishes violation of these provisions as a Class B misdemeanor for knowing or intentional breaches by PBMs.
Legislative Description
Pharmacy benefits managers. Specifies requirements that apply to a pharmacy benefits manager, including fiduciary duties owed a covered entity and contractual requirements for contracts with pharmacies. Provides that a pharmacy benefits manager who knowingly or intentionally violates these provisions commits a Class B misdemeanor.
Last Action
Representatives Carbaugh and Hale added as coauthors
1/22/2015