Rep. Steve Sheldon (R) has introduced legislation to comprehensively regulate Pharmacy Benefit Managers. House Bill 203 would regulate PBMs in commercial and self-insured plans, as well as the state employee plan. The bill includes patient choice of pharmacy protections and measures that protect pharmacy reimbursed. It would also prohibit mandatory mail order, require any rebates to reduce patients’ out-of-pocket costs and set a pharmacy reimbursement floor based on NADAC + professional dispensing fee. Additionally, it would require PBMs to treat 340B claims like other prescription claims for reimbursement purposes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.