HB 1291

Abstract

Medical assistance services; managed care organization contracts with pharmacy benefits managers; spread pricing. Requires the Department of Medical Assistance Services to require a managed care organization with which the Department enters into an agreement for the delivery of medical assistance services to include in any agreement between the managed care organization and a pharmacy benefits manager provisions prohibiting the pharmacy benefits manager or a representative of the pharmacy benefits manager from conducting spread pricing with regard to the managed care organization's managed care plans. The bill defines "spread pricing" as the model of prescription drug pricing in which the pharmacy benefits manager charges a managed care plan a contracted price for prescription drugs, and the contracted price for the prescription drugs differs from the amount the pharmacy benefits manager directly or indirectly pays the pharmacist or pharmacy for pharmacist services. The bill applies to agreements entered into, amended, extended, or renewed on or after July 1, 2020. This bill is identical to SB 568.

Medical assistance services; managed care organization contracts with pharmacy benefits managers; spread pricing. Requires the Department of Medical Assistance Services to require a managed care organization with which the Department enters into an agreement for the delivery of medical assistance services to include in any agreement between the managed care organization and a pharmacy benefits manager provisions prohibiting the pharmacy benefits manager or a representative of the pharmacy benefits manager from conducting spread pricing with regards to the managed care organization's managed care plans. The bill defines "spread pricing" as the model of prescription drug pricing in which the pharmacy benefits manager charges a managed care plan a contracted price for prescription drugs, and the contracted price for the prescription drugs differs from the amount the pharmacy benefits manager directly or indirectly pays the pharmacist or pharmacy for pharmacist services. The bill applies to agreements entered into, amended, extended, or renewed on or after July 1, 2020.

Medical assistance services; managed care organization contracts with pharmacy benefits managers; spread pricing. Requiresthe Department of Medical Assistance Services to require a managedcare organization with which the Department enters into an agreement for the delivery of medical assistance services to include in anyagreement between the managed care organization and a pharmacy benefitsmanager provisions prohibiting the pharmacy benefits manager or a representative of the pharmacy benefits manager from conductingspread pricing with regards to the managed care organization's managedcare plans. The bill defines "spread pricing" as the model of prescriptiondrug pricing in which the pharmacy benefits manager charges a managedcare plan a contracted price for prescription drugs, and the contracted price for the prescription drugs differs from the amount the pharmacybenefits manager directly or indirectly pays the pharmacist or pharmacyfor pharmacist services. The bill applies to agreements entered into, amended, extended, or renewed on or after January 1, 2021.