H178 - Access to Prescription Drug Cost Information

• Health benefit plans and pharmacy benefit managers must electronically provide patient-specific prescription drug benefit and cost information at the point of prescribing, dispensing, or through patient-facing tools in real time.

• Real-time information exchange must include eligibility status, formulary coverage, cost-sharing requirements (copayment, coinsurance, deductible), therapeutically equivalent alternatives, and prior authorization requirements using American National Standards Institute-accredited standards.

• Health care professionals cannot be restricted from communicating the full range of prescription drug cost options to patients, including cash-pay options, assistance programs, and coverage through pharmacies of patient choice.

• Payors are prohibited from restricting the display of patient-specific prescription drug benefit and cost information that reflects cost coverage options outside the patient's health benefit plan.

• Act becomes effective January 1, 2023.