Bills › 90th General Assembly
Relating to pharmacy benefits managers, pharmacies, and prescription drug pricing, and providing applicability provisions
Sponsored by the House Commerce Committee
Topics:Business & economyHealth carePrescription drug prices
Where it is now
- Done: IntroducedFebruary 8, 2024
- Skipped: SubcommitteeSkipped
- Done: House committeeMarch 12, 2024
- Done: Passes the HouseMarch 12, 202493–3
- Done: Senate committeeMarch 13, 2024
- Stopped: Passes the SenateDied when the General Assembly ended
- Next: To the Governor
- Next: Signed into law
Died when the session ended The General Assembly adjourned on April 19, 2024. Bills that didn’t pass both chambers died. What’s a funnel?
What’s in it
This bill relates to pharmacy benefits managers (PBMs), pharmacies, and prescription drug pricing. The bill prohibits a PBM from discriminating against a pharmacy or a pharmacist with regards to participation, referral, reimbursement of a covered service, or indemnification if a pharmacist acts within the scope of the pharmacist’s license and the pharmacy is operating in accordance with all applicable laws and rules. The bill requires all contracts executed, amended, adjusted, or renewed on or after July 1, 2024, which are applicable to prescription drug benefits on or after January 1, 2025, between a PBM and a third-party payor, or between a person and a third-party payor, to use a pass-through pricing model; to exclude terms that allow for spread pricing unless the entire amount of the difference caused by spread pricing is passed through by the pharmacy benefits manager; and to ensure that payments received in relation to providing services to a third-party payor or a pharmacy are used or distributed pursuant to the PBM’s contract with the third-party payor or with the pharmacy, or as otherwise required.
Read the full explanation
“Pass-through pricing” and “spread pricing” are defined in the bill. The bill requires a PBM to provide a process for pharmacies to appeal a maximum allowable cost, or a reimbursement made under a maximum allowable cost list. The requirements for the appeal process are detailed in the bill. The bill applies to pharmacy benefits managers that manage a prescription drug benefit in the state on or after July 1, 2024.
From the explanation printed with the bill as introduced, written by the Legislative Services Agency. Amendments adopted later aren’t reflected. Full bill text
Senate subcommittee
Named March 13, 2024. Meeting: Wednesday, March 13 · 9:30 AM · Room 315.
Three legislators hear a bill first and recommend what the committee should do; it’s the best time to weigh in. How to take part
Fiscal note
8 million, as shown in Figure 1, beginning in FY 2025. It is estimated that the lower end of this range is more likely to occur, since offsetting price changes by PBMs, as a result of pharmacy reimbursement rates changing, will decrease the overall effect of MAC requirements in the Bill.
- Regulation of Pharmacy Benefit Managers · April 18, 2024
- Regulation of Pharmacy Benefit Managers · March 8, 2024
Nonpartisan cost estimates from the Legislative Services Agency’s Fiscal Services Division. The newest is first. Reading a fiscal note
Iowa Code it changes
Read from the bill as introduced. Each links to every bill touching that chapter of the Iowa Code. How the Code works
Lobbying
5 for · 19 against · 5 undecided · Who →