The bill amends the Pharmacy Benefits Manager Regulation Act to impose restrictions on the types of fees that pharmacy benefits managers (PBMs) can collect, specifically defining what constitutes a "bona fide service fee." This new definition includes criteria such as being a flat dollar amount, consistent with fair market value, and solely related to the provision of pharmacy benefits management services. Additionally, the bill introduces the concept of a "conflict of interest," which refers to situations where a PBM or its affiliate receives remuneration beyond the bona fide service fee for providing pharmacy benefits management services.

Furthermore, the bill establishes stricter licensing requirements for PBMs, mandating that they must be licensed by the superintendent to operate or provide pharmacy benefits management services. It also outlines conditions under which the superintendent can suspend or revoke a PBM's license, including conflicts of interest and non-compliance with applicable laws. In the event of a license revocation, the PBM is required to conclude its affairs and notify pharmacies in its network, with failure to comply being classified as an unfair or deceptive trade practice under the Unfair Practices Act.

Statutes affected:
introduced version: 59A-61-2, 59A-61-3