SC H4794

Defines "spread pricing" as when a pharmacy benefits manager (PBM) charges health plans a different price for prescription drugs than what they pay pharmacies, and prohibits this practice

Prohibits PBMs from steering patients to pharmacies they own without written disclosure and patient acknowledgment, and bars retaliation if patients choose alternate pharmacies

Requires PBMs to reimburse local pharmacies at rates equal to what they pay chain, mail-order, or specialty pharmacies for the same drugs or services

Mandates that 100% of prescription drug rebates received by insurers must be passed through to reduce enrollees' out-of-pocket costs at the point of sale

Prohibits PBMs from retroactively denying or reducing pharmacy claims after payment, selling patient healthcare information, and requires authorization decisions within 72 hours (24 hours for urgent cases)