OH HB396

Prohibits pharmacy benefit managers from engaging in spread pricing, where they charge plans a higher price than they pay pharmacies for the same drug or services.

Prevents pharmacy benefit managers from retroactively denying claims after adjudication except in cases of fraud, duplicate payment, or improper service rendering.

Requires pharmacy benefit managers to reimburse pharmacies at no less than the national average drug acquisition cost (or wholesale acquisition cost if unavailable) for the ingredient drug product component.

Mandates pharmacy benefit managers report quarterly to the superintendent of insurance on aggregate rebates received and distributed, with information itemized by pharmacy and product and kept confidential.

Extends requirements to health insuring corporations and sickness and accident insurers operating as pharmacy benefit managers, as well as those under contract with medicaid managed care organizations.