Amendment H-1216 to SF 315
Relating to pharmacy benefits manager reverse auctions and group insurance for public employees and including effective date provisions
Never voted on
Filed April 2, 2025 in the House by the House Commerce Committee
What it changes
- Page 5, after line 5 by inserting: “
- All of the following shall be incorporated as terms of the participant bidding agreement and the pharmacy benefits manager’s services contract awarded to the pharmacy benefits manager reverse auction winner: a. The department shall require an average acquisition cost reimbursement methodology for pharmacy ingredient cost reimbursement of all prescription drugs covered by a pharmacy benefits manager. b. A reasonable professional service fee shall be provided to a pharmacist for the pharmacist’s time and service included in dispensing prescription drugs covered by a pharmacy benefits manager. c. A covered person shall not be prohibited from filling a prescription drug order at any pharmacy in the state provided that the pharmacy accepts the same terms and conditions as the pharmacies participating in the covered person’s health benefit plan’s network. d. With the exception of incentives in value-based programs established by a health carrier or a pharmacy benefits manager to promote the use of higher-quality pharmacies, a pharmacy benefits manager shall not impose different cost-sharing or additional fees on a covered person based on the pharmacy at which the covered person fills a prescription drug order. e. A pharmacy benefits manager shall not require a covered person, as a condition of payment or reimbursement, to purchase pharmacy services, including prescription drugs, exclusively through a mail-order pharmacy.”
- Page 5, line 6, by striking “
- ” and inserting “
- ”
- Page 5, line 25, by striking “
- ” and inserting “
- ”