This bill prohibits pharmacy benefit managers (PBMs) from utilizing spread pricing in their contracts for pharmacy benefits management services with carriers, health benefits plans, and pharmacies. Spread pricing refers to the practice where a PBM charges a health benefits plan a different price for a prescription drug than what it pays the pharmacy. The bill mandates that any contract with a PBM must require the manager to remit 100 percent of any rebates, fees, or other remuneration related to drug utilization back to the carrier or purchaser. Additionally, the bill establishes that PBMs must act in good faith and fair dealing with all parties involved in the provision of pharmacy benefits management services.

Furthermore, the bill requires PBMs to submit annual financial statements to the Department of Banking and Insurance, which will be audited and may be requested on a more frequent basis. Starting one year after the bill's enactment, the department is also tasked with providing an annual report to the Governor and Legislature regarding the compensation and pricing of PBMs, including how these factors affect the costs of health benefits plans for covered persons. This report will be made publicly available on the department's website, ensuring transparency in the operations of pharmacy benefit managers.

Statutes affected:
Introduced: 17B:27F-3.1