This bill proposes to amend the Arizona Revised Statutes by adding Section 20-3337, which establishes new regulations for pharmacy benefit managers (PBMs) regarding reimbursement practices for nonaffiliated pharmacists and pharmacies. Under the new law, PBMs would be prohibited from reimbursing these entities for prescription drugs or devices at amounts lower than their actual costs. Additionally, the bill outlines specific requirements for PBMs, including the obligation to pay a professional dispensing fee based on the fee-for-service methodology used in the state medical assistance plan, and to provide a clear appeals process for pharmacists and pharmacies to contest reimbursement rates.

The bill also includes provisions for compliance and accountability, such as requiring PBMs to adjust reimbursement costs if they do not meet the stipulated requirements and to provide necessary information to pharmacists and pharmacies following an appeal. Furthermore, it defines key terms related to nonaffiliated pharmacists and pharmacies, and specifies that these regulations will apply to contracts entered into or renewed after December 31, 2026. Overall, the bill aims to enhance transparency and fairness in the reimbursement process for nonaffiliated pharmacies and pharmacists.

Statutes affected:
Introduced Version: 20-3337