NV SB149

Department of Health and Human Services must select and contract with a single "state pharmacy benefit manager" to manage all pharmacy benefits for Medicaid, the Children's Health Insurance Program, and certain other health benefit plans, replacing the current system allowing multiple PBMs or health maintenance organizations

Medicaid managed care organizations are required to contract with and utilize the state pharmacy benefit manager to administer all pharmacy benefits for their Medicaid recipients

State pharmacy benefit manager is prohibited from using spread pricing, requiring patients to use specific pharmacies or mail order distributors, imposing fees without Department approval, and reducing pharmacy reimbursements through various fee mechanisms like direct or indirect remuneration fees

Department must approve all contracts between the state PBM and pharmacies before they become effective, and violations of payment obligations to pharmacies carry penalties of $25,000 per day

Effective January 1, 2026, with existing PBM/HMO contracts allowed to continue until their current terms expire