The General Assembly Raised Bill No. 1366 aims to enhance regulations surrounding pharmacy benefits managers (PBMs) and their contracts with health carriers and pharmacies. Key provisions include prohibiting contracts that penalize pharmacists for disclosing medication costs or alternative purchasing methods, and allowing PBMs to charge health benefit plans different prices for pharmacy services starting January 1, 2026. Additionally, the bill establishes that PBMs must act in a fiduciary capacity towards health carriers, pharmacies, and covered persons, ensuring that their duties to covered individuals take precedence over those owed to health carriers.

Furthermore, the bill mandates annual reporting by the Insurance Commissioner on the rebate practices of health carriers, including how rebates are accounted for in premium calculations and their impact on cost-sharing requirements. The report will also evaluate the effectiveness of rebate practices in reducing costs for consumers. The bill repeals and substitutes existing statutes to incorporate these new requirements, with the aim of promoting transparency and fairness in pharmacy benefit management.

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