This bill mandates that the cost-sharing amounts for certain prescription drug benefits be determined based on the final cost incurred by the carrier. Specifically, it requires that any cost-sharing paid by a covered person for a prescription drug reflects the final amount paid by the carrier after accounting for any price negotiations conducted by the carrier or a pharmacy benefits manager, as well as any compensation received from pharmaceutical manufacturers or related entities.
The bill defines "carrier" to include various licensed health insurance entities, as well as the State Health Benefits Program and the School Employees' Health Benefits Program. It also provides a broad definition of "compensation," encompassing any financial benefits related to the utilization of health benefits plans. The act is set to take effect immediately and will apply to health benefits plans issued or renewed on or after January 1 of the following calendar year after its enactment.