HF 1576 Summary

• Prohibits pharmacy benefit managers and health carriers from restricting pharmacies or pharmacists from disclosing to enrollees information about treatment nature, risks, alternatives, utilization review decisions, authorization processes, and financial incentives and structures.

• Requires pharmacies to provide enrollees with information about total prescription drug costs, including co-payment amounts, usual and customary prices, acquisition costs, and reimbursement amounts paid by the pharmacy benefit manager or health carrier.

• Prohibits pharmacy benefit managers from preventing pharmacists or pharmacies from discussing with health carriers the reimbursement amounts or acquisition costs for prescription drugs.

• Prohibits pharmacy benefit managers and health carriers from restricting discussion of therapeutically equivalent alternative prescription drugs or alternative purchasing methods, including paying out-of-pocket when the pharmacy's usual and customary price is less expensive than the health plan's required cost.