HF294 Summary

• Requires health plan prescription drug formularies to be filed with the commissioner, with proposed revisions due by August 1 of the application year.

• Mandates drug manufacturers report prescription drug prices to the commissioner beginning July 31, 2024, for drugs costing $100 or more for a 30-day supply, including national drug code, brand/generic name, wholesale acquisition cost, and average wholesale price.

• Requires manufacturers to provide 90 days' written notice to the commissioner before increasing wholesale acquisition costs for drugs included in filed health plan formularies.

• Establishes real-time prescription benefit tool requirements for group purchasers and pharmacy benefit managers to notify prescribers of drug coverage, formulary status, patient cost-sharing, prior authorization requirements, and alternative drug options.

• Requires health plan companies to disclose formularies and benefit information electronically at least 30 days before renewal, organized according to United States Pharmacopeia guidelines, with restrictions on formulary changes during enrollee contract terms and 60-day notice requirements for changes increasing enrollee costs.