This bill aims to amend existing insurance laws in Nebraska by introducing new provisions that protect patients' access to clinician-administered drugs and regulate the actions of pharmacy benefit managers (PBMs). It prohibits insurance policies and health plans from imposing restrictions on the authorization, payment, or coverage of clinician-administered drugs, including penalties for obtaining these drugs from authorized providers. Additionally, the bill ensures that patients can choose their providers without interference from insurers and mandates that coverage cannot be denied based on the source of the drug, as long as medical necessity criteria are met.

Furthermore, the bill includes provisions that prevent pharmacy benefit managers from restricting how retail community pharmacies dispense or deliver prescription drugs, including prohibiting them from requiring participation in mail-order contracts. It also establishes criteria for Nebraska pharmacies to participate in specialty pharmacy networks, ensuring that the terms and conditions set by PBMs are reasonable and not excessively burdensome. The bill provides for severability, meaning that if any part is found unconstitutional, the remaining sections will still be valid. The original sections of the law being amended are repealed.

Statutes affected:
Introduced: 44-4606, 44-4610