SB 3072

Bill Subjects

Abstract

Requires pharmacy benefit managers to notify contracting pharmacies of changes to maximum allowable costs by the National Drug Code fifteen days prior to the change. Requires pharmacy benefit managers to disclose where an equivalent drug can be obtained at or below the maximum allowable cost, when a maximum allowable cost appeal is upheld on appeal. Requires pharmacy benefit managers to: allow contracting pharmacies to reverse and rebill claims if the pharmacy benefit manager establishes a maximum allowable cost that is denied on appeal; and pay the difference to the contracting pharmacies. Permits contracting pharmacies to decline to dispense a drug if the reimbursement is less than the acquisition cost. Permits the insurance commissioner to suspend a pharmacy benefit manager's certification if the manager does not comply with state law. Requires the Department of Health to annually report to the legislature and any other state agency on appeals and disposition.