NV SB316

Expands pharmacy benefit manager (PBM) regulation to cover pharmacist services in addition to prescription drugs, and prohibits PBMs from requiring patients to use affiliated pharmacies when non-affiliated options exist in the network.

Prohibits insurers from imposing cost-sharing obligations (copays, coinsurance, deductibles) on prescription drugs that exceed the net price paid after rebates, calculated at point-of-sale.

Requires PBMs to submit annual reports to the Commissioner detailing drug pricing, rebates, fees, and business practices; health insurers must submit similar reports on prescription drug spending by June 1 annually.

Establishes civil penalties of $1,000-$7,500 per violation for PBMs that violate the law, with violations also constituting misdemeanors; creates a fiduciary duty for PBMs toward covered persons.

Exempts ERISA-covered employer plans, Public Employees' Benefits Program, local government employee insurance plans, and Medicaid managed care organizations from the new PBM requirements; effective January 1, 2026.