Senate Bill 2894 Summary

• Establishes minimum reimbursement rates for pharmacies at the national average drug acquisition cost plus an $11.29 dispensing fee, or wholesale acquisition cost if national average is unavailable, prohibiting pharmacy benefit managers from reimbursing below these amounts.

• Creates new anti-discrimination protections for 340B Drug Discount Program entities, prohibiting differential reimbursement rates, unequal fees, network exclusions, or claim modifiers based on 340B participation.

• Requires pharmacy benefit managers to provide a 45-business-day appeal process for pharmacies to challenge reimbursement rates, with uphold appeals requiring payment adjustments applied to all similarly situated pharmacies.

• Extends licensing and regulation by the State Board of Pharmacy to pharmacy services administrative organizations, including annual financial reporting and examination requirements.

• Prohibits pharmacies, pharmacy benefit managers, and their affiliates from coercing patients to use affiliate pharmacies, penalizing non-affiliate pharmacy choices, retaliating against pharmacists for exercising statutory rights, or interfering with patient pharmacy choice.