Amendment H-8179 to HF 2401

Filed March 8, 2024 in the House by

What it changes

1. Page 1, before line 1 by inserting: “DIVISION I PHARMACY BENEFITS MANAGERS”
2. Page 1, by striking lines 6 through 14 and inserting “prescription drugs are equivalent to the payments the pharmacy benefits manager makes to the dispensing pharmacy or dispensing health care provider for the prescription drugs, including any professional dispensing fee.”
3. Page 3, by striking lines 11 and 12 and inserting: “a. If a pharmacy’s appeal is found to be substantiated, the pharmacy benefits manager shall do all of the”
4. Page 3, by striking lines 27 and 28 and inserting: “b. If a pharmacy’s appeal is found to be unsubstantiated, the pharmacy benefits manager shall do all of the”
5. Page 4, line 11, after “rate.” by inserting “The adjustment to the maximum allowable cost or the reimbursement rate shall be applicable to all of the following:”
6. Page 4, after line 11 by inserting: “(a) Each pharmacy that is under common ownership with the pharmacy that submitted the appeal. (b) Each pharmacy in the state that demonstrates the inability to purchase the prescription drug for less than the established maximum allowable cost or reimbursement rate.”
7. Page 4, line 12, after “This” by inserting “division of this”
8. Page 4, after line 14 by inserting: “DIVISION ___ PHARMACY SERVICES ADMINISTRATIVE ORGANIZATIONS AND WHOLESALE DISTRIBUTION —— REPORT Sec. ___. PHARMACY SERVICES ADMINISTRATIVE ORGANIZATIONS AND WHOLESALE DISTRIBUTION OF PRESCRIPTION DRUGS —— REPORT. Before January 1, 2025, the commissioner or the commissioner’s designee shall review pharmacy services administrative organizations and the wholesale distribution of prescription drugs, and submit a report to the general assembly containing findings and recommendations based on the review. The report shall contain, at a minimum, all of the following:
9. A description and analysis of the prescription drug wholesale distribution supply chain, including an analysis of the concentration of the market for the wholesale distribution of prescription drugs, margins in the wholesale distribution of prescription drugs, and the availability of competition in the wholesale distribution of prescription drugs.
10. A description of the role that pharmacy services administrative organizations serve in the prescription drug supply chain.
11. A description and analysis of the relationships between pharmacy services administrative organizations, prescription drug wholesalers, and retail pharmacies, including standard contracting terms, fees charged to pharmacies, and contractual restrictions and limitations applicable to retail pharmacies.”
12. By renumbering as necessary.

Official amendment (PDF) · In the Bill Book