SB 376

Abstract

Prescription Drug Affordability Board; established; drug cost affordability review. Establishes the Prescription Drug Affordability Review Board for the purpose of protecting state residents, state and local governments, commercial health plans, health care providers, pharmacies licensed in the Commonwealth, and other stakeholders within the health care system from the high costs of prescription drug products. The bill directs the Governor to appoint members and alternate members of the Board. The Board is required to meet in open session at least four times annually, with certain exceptions and requirements. Members of the Board are required to disclose any conflicts of interest, as described in the bill. The bill also creates a stakeholder council for the purpose of assisting the Board in making decisions related to drug cost affordability. The Board is tasked with identifying prescription, generic, and other drugs, as defined in the bill, and, in the Board's discretion, conducting an affordability review of the prescription drug product. Factors for the Board to consider that indicate an affordability challenge are listed in the bill. Any person aggrieved by a decision of the Board may request an appeal of the Board's decision, as provided in the bill, and the Attorney General shall have authority to enforce the provisions of the bill.The bill also creates the Prescription Drug Affordability Fund to be used for funding operations of the Board and reimbursing other state agencies for implementing the provisions of the bill. The Board is required to report to the General Assembly twice annually, beginning on July 1, 2023, and December 1, 2023.Provisions of the bill shall apply to state-sponsored and state-regulated health plans and health programs and obligate such policies to limit drug payment amounts and reimbursements to an upper payment limit amount set by the Board, if applicable, following an affordability review. Medicare Part D plans shall not be bound by such decisions of the Board.The bill contains a severability clause and has a delayed effective date of January 1, 2023.