Present law authorizes the TennCare bureau to develop prescription drug programs and to contract with one or more pharmacy benefit managers (PBMs) or other appropriate third party contractors to administer all or a portion of such prescription drug programs for the TennCare program. This bill removes the authorization for contracting with a pharmacy benefit manager, but retains authorization for contracting with other appropriate third party contractors. This bill removes related references to PBMs in the code. This bill removes the present law provision whereby the bureau may require the setting of pharmacy reimbursement rates and dispensing fee schedules necessary to maintain an adequate retail pharmacy network and increase the cost-effectiveness of state pharmacy purchases. This bill removes the present law provision whereby the following documents submitted to the state in response to a request for proposal or other procurement method remain confidential after completion of the evaluation period: discount, rebate, pricing or other financial arrangements at the individual drug level between pharmaceutical manufacturers, pharmaceutical wholesalers/distributors, and pharmacy benefits managers that a proposer: submits to the state in response to a request for proposals or other procurement methods for pharmacy-related benefits or services; includes in its cost or price proposal, or provides to the state after the notice of intended award of the contract is issued, where the proposer is the apparent contract awardee; and explicitly marks as confidential and proprietary.

Statutes affected:
Introduced: 56-7-3103(a)(1), 56-7-3103