OH HB509

Health plan issuers must calculate a covered person's cost-sharing for prescription drugs at the point of sale using a price reduced by 100% of all rebates received or to be received from manufacturers, pharmacies, or other parties.

"Rebate" includes negotiated price concessions, base price concessions, price protection rebates, performance-based price concessions, and reasonable estimates of fees and administrative costs that reduce the health plan issuer's liability for prescription drugs.

Health plan issuers and their agents are prohibited from publishing or revealing actual rebate amounts on a product, therapeutic class, manufacturer, or pharmacy-specific basis, with violations constituting unfair and deceptive insurance practices.

Rebate information and related documents are classified as confidential and not public records, and health plan issuers must impose confidentiality requirements on any agents or third parties with access to rebate information.

Health plan issuers may voluntarily decrease a covered person's cost-sharing by more than the amount required by this section, and the superintendent of insurance shall regulate only to the extent permissible under applicable law.