SB 478-FN is a legislative bill designed to improve prescription drug affordability and enhance accountability among pharmacy benefit managers (PBMs) in New Hampshire. The bill introduces several key regulatory changes, including the prohibition of spread pricing and retroactive fees on clean claims, while mandating that all manufacturer rebates be passed through to insurers or plan members. It also requires PBMs to provide timely access to pricing lists and allows for audits to ensure compliance, with a focus on using the lowest net cost drugs. Additionally, the bill emphasizes transparency in PBM operations and their relationships with health carriers and consumers, while safeguarding competitively sensitive information.

The legislation includes the repeal and reenactment of RSA 402-N:9, which establishes new definitions and obligations for PBMs, such as a duty to operate with care and in the best interests of enrollees and health plans. It prohibits PBMs from deriving income based on drug prices and mandates that their fees be clearly defined in agreements. Other provisions include the prohibition of gag clauses that prevent pharmacists from sharing the lowest prices with patients, the establishment of standards for the reimbursement of 340B covered entities, and the requirement for electronic prior authorization processes. The bill also introduces a consumer out-of-pocket smoothing option for pharmacy costs and mandates annual reporting by PBMs on rebates and fees, with the aim of fostering a more equitable and transparent system for managing prescription drug costs.

Statutes affected:
Introduced: 402-N:1, 402-N:3, 402-N:4
SB478 text: 402-N:1, 402-N:3, 402-N:4