The Kansas Consumer Prescription Protection and Accountability Act aims to enhance the regulation of pharmacy benefits managers (PBMs) and establish clear guidelines for pharmacy audits. Key provisions include requirements for auditing entities to maintain confidentiality, provide prior notice of audits, and deliver audit reports within specified timeframes. The bill prohibits chargebacks or recouping penalties until the appeals process is complete and restricts the use of extrapolation in penalty calculations. It also outlines the conditions for conducting pharmacy audits, ensuring that clerical errors do not lead to chargebacks unless they result in overpayments. Additionally, PBMs are required to register with the commissioner, report financial details, and adhere to reimbursement standards that protect pharmacies.

The bill further amends existing laws to clarify the licensing and regulation of PBMs, including the requirement for a valid license to operate in Kansas. It expands the definition of "covered entity" and emphasizes compliance, allowing the commissioner to examine PBMs for adherence to state laws. The legislation mandates that PBM contracts be provided to pharmacies within ten days of execution and establishes penalties for non-compliance, including fines and potential license revocation. The act also ensures that co-payments for prescription drugs do not exceed the total submitted charges by network pharmacies and allows pharmacists to inform covered individuals about their cost-sharing options. Overall, the bill seeks to improve transparency, accountability, and consumer protection within the pharmacy benefits management sector in Kansas.

Statutes affected:
As introduced: 40-2102, 40-2109, 40-3116, 40-3413, 75-4101
As Amended by House Committee: 40-2102, 40-2109, 40-3116, 40-3413, 75-4101
Enrolled: 40-202, 40-222, 40-3821, 40-3822, 40-3823, 45-229, 40-3824, 40-3825, 40-3826, 40-3827, 40-3828a, 40-3831, 40-3829, 40-3830