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 fee must be a flat dollar amount, consistent with fair market value, and solely related to the provision of pharmacy benefits management services. Additionally, the bill introduces definitions for terms such as "conflict of interest," which refers to situations where a PBM derives remuneration beyond the bona fide service fee, and "maximum allowable cost," which pertains to the reimbursement limits for generic drugs.

Furthermore, the bill establishes stricter licensure requirements for PBMs, mandating that they must be licensed by the superintendent to operate or provide pharmacy benefits management services. It outlines the conditions under which a license may be revoked, including conflicts of interest and non-compliance with applicable laws. The bill also stipulates that if a PBM's license is revoked, it must conclude its affairs and notify pharmacies in its network, with non-compliance constituting an unfair or deceptive trade practice. Overall, the legislation aims to enhance transparency and accountability in the operations of pharmacy benefits managers.

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