House Bill 2333, also known as Senate Bill 2574, aims to regulate the actions of pharmacy benefits managers (PBMs) in Tennessee. The bill establishes that PBMs cannot modify, restrict, or deny medications prescribed by healthcare prescribers unless a formulary exception or prior authorization is requested by the prescriber. It emphasizes that only healthcare prescribers have the authority to issue, modify, or discontinue medications, and any health plan provisions granting PBMs conflicting authority are deemed void. Additionally, the bill mandates that PBMs must ensure affordable access to medically necessary medications and respond to prior authorization requests within specified time frames, with automatic approval if they fail to respond.

The legislation also prohibits retaliatory actions by PBMs against pharmacies or healthcare prescribers exercising their rights under this section, and it requires PBMs to disclose contract terms and rebate arrangements to the Department of Commerce and Insurance upon request. Furthermore, PBMs must report annual data on prior authorization response times and approval rates. Violations of this section are classified as unfair trade practices, subjecting PBMs to civil penalties and allowing affected parties to seek legal remedies. The bill includes a severability clause and specifies that it will take effect upon becoming law for rule promulgation, with full implementation set for July 1, 2026.

Statutes affected:
Introduced: 56-7-3122, 56-8-104