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2018 Enacted State Laws Affecting Pharmacy Benefit Managers (PBMs)January 2019 - NCSL Health Program State legislatures passed over 30 laws banning the practice of “gag clauses” restricting pharmacists fromdiscussing different drug pricing options in pharmacy benefit management (PBM) contracts with pharmacies.Multiple states enacted legislation either requiring PBMs to register with the state or acquire a license to work as aPBM.Many states have passed legislation prohibiting “clawback” practices, when there is a discrepancy in pricebetween the cost of a drug and the co-pay and the PBM keeps the difference.State policymakers can use this guide to learn about recent state actions or inform future decisions.IntroductionOver the past year, state legislators pursued new legislation that regulates the practices of PBMs: those who negotiatedrug prices and rebates as middlemen between insurance providers and pharmacies. Because of legislative interest in abroad range of pharmaceutical pricing issues, states have enacted a diverse set of policy initiatives, including thisselection of enacted legislation with at least 41 signed bills from 23 states. This search is based on the following topicfilters in the NCSL Statewide Prescription Drug Database: Cost Sharing and Deductibles, Pharmaceutical Pricing andPayment, Rx Medicaid Use and Cost and Pharmacy Benefit Managers.Of the measures included in this report, some of the legislative themes involve regulating contractual “gag clauses”between PBMs and pharmacies, and requiring PBMs to either register with the state or obtain a license to operatewithin state boundaries. Please refer to NCSL’s separate report on this issue titled “Prohibiting PBM ‘Gag Clauses’ thatRestrict Pharmacists from Disclosing Price Options: Recent State Legislation 2016-2018” for an in-depth explanation ofwhat a gag clause is and what states enacted as well as filed bills that failed to prohibit gag clauses in recent years. Thelegislation contained in this report represents a wide variety of approaches in a diverse mix of states and is intended togive the reader a comprehensive overview of approaches taken by states over the last year that affect PBMs.
This report compiles enacted legislation excerpted from the NCSL Prescription Drug Online Database. The full NCSLdatabase of enacted legislation from 2015 to present details at least 169 enacted bills and resolutions from 44 states,which is not intended to be exhaustive of every possible bill. Entries to this report are listed alphabetically by state andchronologically by year for each state. A reference table of included topics listing which states have enacted relevantlegislation is provided below. One bill may apply to multiple categories.Enacted Legislation by Topic and Number of StatesProhibiting Gag Clauses, Price Transparency and Preventing Clawbacks: Prohibiting PBM contracts from barringpharmacists from advising patients on different payment methods or drug options when filling their prescription. Someof these laws also prevent the practice of clawbacks, where PBMs take back the amount a customer pays as a co-paythat is above the actual price of the drug.18 States: Alabama, Arizona, Arkansas, California, Colorado, Delaware, Florida, Kansas, Kentucky, Louisiana, Maine,Maryland, Mississippi, New Hampshire, South Carolina, South Dakota, Tennessee, Vermont,Requiring Registration or Licensing of PBMs: Determining the method, fees and guidelines for either licensing orregistering PBMs through the state pharmacy board.4 States: Alaska (registration), Arkansas (licensing), Iowa (wholesale distribution licensing), Tennessee (licensing).Preventing Non-state Private PBM Licensing and Accreditation: Stipulating that the only entity with the authority tolicense or give accreditation to PBMs is the state board of pharmacy.1 State: New Hampshire.Procedures and Guidelines for Pharmacy Auditing: Outlining methods and procedures for how pharmacies can beaudited by the state to prevent fraud and increase pricing transparency.3 States: Alaska, Georgia, Utah.Disclosing Drug Price Increases: Mandating that pharmacy benefit managers must inform government offices of largedrug price increases and or give justifications for doing so.
4 States: California, Connecticut, Kentucky, Vermont.Step Therapy/Prior Authorization: Step therapy, also called “fail first,” is when an insurance provider requires thatcertain drug treatments are prescribed before switching to a more expensive or non-generic drug treatment alternative.Prior authorization is requiring that a consumer must first obtain permission from a physician to access certain drugsthrough their insurance provider.3 States: Delaware, Minnesota, VermontTopics beyond those covering Pharmacy Benefit Management are tracked and reported by NCSL online. Those topicsinclude: Biologics and Biosimilars Clinical Trials and Right to Try Compounding Pharmacy Regulation Insurance/Coverage - Rx Drugs Safety and Errors - Rx Drugs Specialty Pharmaceuticals Utilization Management - Rx Drugs Other Prescription Drug MeasuresBill InformationSummaryAlabamaAL H 4572018Pharmacies and PharmacistsStatus: Enacted - Act No. 2018-457Date of Last Action:* 03/28/2018 - EnactedAuthor: Beech (D)Associated Bills: AL S 348 - CompanionAmends Sections 34-23-181, 34-23-184, 34-23-185, and 34-23-186 ofthe Code of Alabama 1975. Addresses auditing procedures forpharmacy records, provides auditing procedures for PBMs, limitsrecoupment due to overpayment for clerical and record-keepingerrors by a pharmacy.AlaskaAK S 372018Board of Pharmacy Inspection and LicensingStatus: Enacted - Act No. 2018-66Date of Last Action:* 07/24/2018 - EnactedAuthor: Giessel (R)To fulfill its responsibilities, the board has the powers necessary forimplementation and enforcement of this chapter, including the powerto license and inspect the facilities of wholesale drug distributors,third-party logistics providers (PBMs), and outsourcing facilitieslocated outside the state under AS 08.80.159.AK H 2402018Pharmacy Benefits ManagersStatus: Enacted - Act No. 2018-100Date of Last Action: 09/04/2018 - EnactedAuthor: Guttenberg (D)Relates to the registration and duties of PBMs, including procedures,guidelines, and enforcement mechanisms for pharmacy audits, bansgag clauses related to the cost of multi-source generic drugs andinsurance reimbursement procedures, authorizes a role for thedirector of the division of insurance affecting drug benefits.Arizona
AZ H 21072018Prescription Drug Pricing Patient Notification ActStatus: Enacted - Act No. 133Date of Last Action: 04/05/2018 - EnactedAuthor: Syms (R)Relates to prescription drug costs: Provides that a PBM or other entitythat administers prescription drug benefits 'may not prohibit bycontract a pharmacy or pharmacist from informing the patient thatthe patient may be able to procure a prescription medication at alower cost, including by paying the cash price.'' (no gag clauses)ArkansasAR H 10102018Pharmacy Manager BenefitsStatus: Enacted - Act No. 1Date of Last Action: 03/15/2018 - EnactedAuthor: Gray (D)Creates the State Pharmacy Benefits Manager Licensure Act. Gagclauses prohibited: ''A pharmacy or pharmacist may provide to aninsured information regarding the insured's total cost for pharmacistservices for a prescription drug. A pharmacy or pharmacist shall not beproscribed by a pharmacy benefits manager from discussinginformation regarding the total cost for pharmacist services for aprescription drug or from selling a more affordable alternative to theinsured if a more affordable alternative is available.''CaliforniaCA S 172018Health Care: Prescription Drug CostsStatus: Enacted - Act No. 2017-603Date of Last Action:* 10/09/2017 - EnactedAuthor: Hernandez (D)Requires pharmaceutical manufacturers to submit to public andprivate purchasers (including state agencies, health insurers, andPBMs) 90-day advance notification of price increases for prescriptiondrugs currently on the market, including detailed informationregarding the reasons and justification for such increases, as well asjustification of launch prices for new drugs. Requires health insurersthat file rate information to report specified cost informationregarding covered prescription drugs, including generic drugs, brandname drugs, and specialty drugs. Requires reporting the percentage ofthe insurance premium attributable to prescription drugs.CA A 3152018Pharmacy Benefit ManagementStatus: Enacted - Act No. 2018-905Date of Last Action:* 09/29/2018 - EnactedAuthor: Wood (D)Requires a pharmacy to inform a customer at the point of sale for acovered prescription drug whether the retail price is lower than theapplicable cost sharing amount for the prescription drug, unless thepharmacy automatically charges the customer the lower price.Requires the pharmacy to submit a claim to a plan or insurer when acustomer pays the retail price. Imposes additional requirements onhealth care service plans regarding contracted pharmacy providersand benefit managers.CA S 10212018Prescription DrugsStatus: Enacted - Act No. 2018-787Date of Last Action:* 09/26/2018 - EnactedAuthor: Wiener (D)Prohibits a drug formulary maintained by a health insurer or a healthcare service plan from containing more than four tiers and permits abiologic with a therapeutic equivalent to be placed on a tier otherthan tier four, as specified. Requires a prescription drug benefit toprovide that an enrollee or an insured is not required to pay morethan the retail price for a prescription drug if a pharmacy's retail priceis less than the applicable copayment or coinsurance amount.
CA A 28632018Health Care Coverage: PrescriptionsStatus: Enacted - Act No. 2018-770Date of Last Action:* 09/26/2018 - EnactedAuthor: Nazarian (D)Limits the amount a health care service plan or health insurer mayrequire an enrollee or insured to pay at the point of sale for a coveredprescription to the lesser of the applicable cost sharing amount or theretail price. Provides that a payment rendered by an enrollee orinsured constitutes the applicable cost sharing.ColoradoCO H 12842018Disclosure of Prescription Costs at PharmaciesStatus: Enacted - Act No. 181Date of Last Action:* 04/30/2018 - EnactedAuthor: Buckner (D)Concerns the cost of prescription drugs purchased at a pharmacy.Prohibits gag clauses in contracts between PBMs and pharmacists thatprevent them from discussing other effective, alternative prescriptiondrug options with customers.
ConnecticutCT H 53842018Prescription Drug CostsStatus: Enacted - Act No. 18-41Date of Last Action:* 05/31/2018 - EnactedAuthor: Mushinsky (D)Requires manufacturers to disclose net drug cost after rebates and toinform the state Office of Health Strategy when a company hassubmitted a drug approval application to the U.S. Food and DrugAdministration, requires disclosing price increase justifications to theOffice, which must be posted on the state website. Requires the Officeof Health Strategy to annually list the top 10 drugs whose wholesaleacquisition cost has increased by 25 percent and that representsubstantial state spending. Imposes additional disclosure andreporting requirements on pharmacy benefits managers, healthcarriers, pharmaceutical manufacturers, the Office of Health Strategyand the Insurance Department concerning prescription drug rebatesand the cost of prescription drugs.DelawareDE H 4252018Permitted Prescription Drug DisclosuresStatus: Enacted - Act No. 378Date of Last Action:* 08/28/2018 - EnactedAuthor: Bennett A (D)Establishes that a contract between a pharmacy benefits manager anda pharmacy may not prohibit a pharmacy or pharmacist fromproviding an insured with information regarding the retail price of aprescription drug, the amount of the cost share for which the insuredis responsible for a prescription drug.DE H 4412018Pharmacy BenefitsStatus: Enacted - Act No. 379Date of Last Action:* 08/28/2018 - EnactedAuthor: Carson (D)Relates to PBM prior authorization of emergency prescriptions andprescriptions for chronic or long-term conditions.FloridaFL H 3512018Pharmacy Benefits ManagersStatus: Enacted - Act No. 2018-91Date of Last Action:* 03/23/2018 - EnactedAuthor: Santiago (R)Associated Bills: FL S 1494Relates to pharmacy benefits managers, prohibits a managed careplan from contracting with a pharmacy benefits manager to managethe prescription drug coverage provided under the plan unless certainrequirements are met. Pharmacist ''shall inform customers of a lessexpensive, generically equivalent drug product for her or hisprescription and whether the cost-sharing obligation exceeds theretail price of the prescription in the absence of prescription drugcoverage.''GeorgiaGA H 2062018Clerical Errors by Providers of Medical AssistanceStatus: Enacted - Act No. 68Date of Last Action:* 05/01/2017 - EnactedAuthor: Kelley (R)Relates to medical assistance and amends requirements relating tocertain audits conducted by the Department of Community Health.States that clerical or other errors do not constitute a basis to recouppayments made by providers of medical assistance and provides a 30day correction period. Amends code relating to appropriationsinvolved with state plans for medical assistance. Repeals conflictinglaws.
IowaIA S 22982018Pharmacy RegulationStatus: Enacted - Act No. 1141Date of Last Action:* 05/16/2018 - EnactedAuthor: Human Resources CommitteeRelates to the Board of Pharmacy composition and amends rulesrelating to the limited distributor license and the wholesaledistribution of prescription drugs and devices, includes penalties.KansasKS S 3512018Pharmacy Patients Fair Practices ActStatus: Enacted - Act No. 2018-23Date of Last Action:* 03/29/2018 - EnactedAuthor: Public Health and Welfare CommitteeEnacts the Kansas Pharmacy Patients Fair Practices Act, states that apharmacy or pharmacist shall have the right to provide a coveredperson with information regarding the amount of cost share for aprescription drug, provides that co-payments applied by a healthcarrier for a prescription drug may not exceed the total submittedcharges by the network pharmacy.KentuckyKY S 52018Medicaid Program Pharmacy BenefitsStatus: Enacted - Act No. 157Date of Last Action:* 04/13/2018 - EnactedAuthor: Wise (R)Requires the Department for Medicaid Services to directly administerall outpatient pharmacy Medicaid benefits, prohibits renewal ornegotiation of new contracts to provide Medicaid managed care thatallow administration of outpatient benefits by any entity but theDepartment for Medicaid Services, reduces costs of future Medicaidmanaged care contracts by costs of all outpatient pharmacy benefitsas they existed on a specified date. Department for Medicaid Servicesmay change reimbursement rates, PBMs must give Department 30days notice of proposed changes over 5 percent.KY H 4632018Pharmacy BenefitsStatus: Enacted - Act No. 144Date of Last Action:* 04/10/2018 - EnactedAuthor: Meredith (R)Defines cost sharing, prohibits an insurer, PBM or other administratorfrom requiring payment for prescription drugs more than certainamounts, prohibits an insurer, PBM, or other administrator fromimposing a gag clause' or penalty on a pharmacist or pharmacy forcomplying as required. Any amount paid by the insured will be counttoward any annual out-of-pocket maximums under their healthbenefit plan.LouisianaLA S 1082018Medicaid Managed CareStatus: Enacted - Act No. 482Date of Last Action:* 05/25/2018 - EnactedAuthor: Johns (R)Revises provisions relating to the Medicaid Managed Care AnnualReport. Requires the Department of Health to submit certain dataquarterly regarding the Medicaid expansion population and services.Amends composition of information in the medical loss ratio of eachmanaged care organization. Requires the quarterly submission ofcertain data regarding PBMs.LA S 1302018Medicaid Pharmacy Benefit ManagementServicesEstablishes requirements for Medicaid contracts or subcontracts forPBM services. Includes provisions on fees, supplemental rebates,pricing, and contract termination.
Status: Enacted - Act No. 483Date of Last Action:* 05/25/2018 - EnactedAuthor: Mills (R)LA S 2412018Prescription Drug Cost OptionsStatus: Enacted - Act No. 317Date of Last Action:* 05/18/2018 - EnactedAuthor: Morrell (D)Provides that ''No PBM or other entity that administers prescriptiondrug benefits in Louisiana shall prohibit by contract a pharmacy orpharmacist from informing a patient of all relevant options whenacquiring their prescription medication, including but not limited tothe cost and clinical efficacy of a more affordable alternative if one isavailable and the ability to pay cash if a cash payment for the samedrug is less than an insurance copayment or deductible paymentamount.”LA S 2822018Health InsuranceStatus: Enacted - Act No. 579Date of Last Action:* 05/31/2018 - EnactedAuthor: Mills (R)Provides definitions related to prescription drug pricing, includingexcess consumer cost burden, health insurance coverage, healthinsurance issuer and rebates. Requires issuers to disclose informationrelating to the prescription drug consumer cost burden. Forbids issuerfrom disclosing certain information regarding rebates due to traderules.LA S 2832018Health InsuranceStatus: Enacted - Act No. 371Date of Last Action:* 05/20/2018 - EnactedAuthor: Mills (R)Relates to PBMs. Provides for internet publication of formularies,transparency reporting, and reportable aggregate data. Provides forthe duties of the commissioner of insurance relative thereto andprovides for confidentiality.LA H 4362018Coverage of Prescription DrugsStatus: Enacted - Act No. 597Date of Last Action:* 05/31/2018 - EnactedAuthor: Johnson (D)Provides amendments for the regulation of PBMs and maximumallowable cost (MAC). PBMs are not allowed to prohibit pharmaciesfrom disclosing costs and clinical alternatives to patients. Provides forreimbursements to non-affiliate pharmacies. Changes time frame foradministrative appeals relating to MACs.MaineME S 102018Clean Claims Submitted by PharmaciesStatus: Enacted - Act No. 44Date of Last Action:* 05/05/2017 - EnactedAuthor: Gratwick (D)Prohibits a health insurance carrier or PBM from imposing acopayment or other charge that exceeds the cost of a prescriptiondrug, prohibits a carrier or PBM from penalizing a pharmacy providerfor providing information related to an enrollee's out-of-pocket costor the clinical efficacy of a prescription drug or alternative medication(gag clause. If information related to an enrollee's out-of-pocket costor the clinical efficacy of a prescription drug or alternative medicationis available to a pharmacy provider, a carrier or PBM may not penalizea pharmacy provider for providing that information to an enrollee.
MarylandMD S 5762018Pharmacy Benefits ManagersStatus: Enacted - Act No. 218Date of Last Action:* 04/24/2018 - EnactedAuthor: Klausmeier (D)Associated Bills: MD H 736Prevents a pharmacy benefits manager from prohibiting a pharmacyor pharmacist from providing a beneficiary with certain informationregarding a certain retail price or certain cost share for a prescriptiondrug (gag clauses).MD H 7362018Pharmacy Benefits ManagersStatus: Enacted - Act No. 217Date of Last Action:* 04/24/2018 - EnactedAuthor: Bromwell (D)Associated Bills: MD S 576Prevents a pharmacy benefits manager from prohibiting a pharmacyor pharmacist from providing a beneficiary with information regardingthe retail price of a prescription drug or the amount of the cost sharefor a prescription drug for which the beneficiary is responsible (gagclauses). Provides for the construction of the Act.MD H 13492018Pharmacy Benefits ManagersStatus: Enacted - Act No. 451Date of Last Action:* 05/08/2018 - EnactedAuthor: Anderton (R)Associated Bills: MD S 1079Revises regulation of PBMs. Authorizes the Maryland InsuranceCommissioner to require additional information from a PBM in acertain application, requires a PBM to use updated pricing informationin calculating certain payments and alters certain requirements of apharmacy benefits manager. Adds additional clauses for theCommissioner concerning appeals, complaints, fees, and fines.MD H 15582018Prescription DrugsStatus: Enacted - Act No. 461Date of Last Action:* 05/08/2018 - EnactedAuthor: Morales (D)Authorizes, with exceptions, a pharmacist to dispense a quantity of aprescription drug, up to a certain number of authorized dosage unitsor does not exceed a specified number of days. Provides that the Actdoes not apply to a certain controlled dangerous substance or certainprescriptions authorized for a patient.MinnesotaMN H 31962018Health InsuranceStatus: Enacted - Act No. 162Date of Last Action:* 05/19/2018 - EnactedAuthor: Fenton (R)Associated Bills: MN S 2897Establishes a step therapy protocol and step therapy override processfor prescription drug coverage.MississippiMS H 7092018Prescription Drugs Alternative Payment OptionsActStatus: Enacted - Act No. 331Date of Last Action:* 03/08/2018 - EnactedAuthor: Mims (R)Establishes the Prescription Drugs Consumer Affordable AlternativePayment Options Act and allows pharmacists to provide additionalinformation about affordable alternative payment options.
New HampshireNH S 4812018Pharmacy Benefit Manager Study CommitteeStatus: Enacted - Act No. 2018-143Date of Last Action:* 05/30/2018 - EnactedAuthor: Soucy D (D)Establishes a committee to study the impact of PBM manageroperations on cost, administration and distribution of prescriptiondrugs. Committee is to report findings by November of 2018.NH S 5812018Compounding of DrugsStatus: Enacted - Act No. 2018-263Date of Last Action:* 06/12/2018 - EnactedAuthor: Sanborn A (R)The bill amends the definition of compounding for the law regulatingpharmacists and pharmacies. Also establishes a study committee tostudy rule-making authority for reconstituted drugs.NH S 5912018Pharmacy Benefit ManagersStatus: Enacted - Act No. 2018-236Date of Last Action:* 06/08/2018 - EnactedAuthor: Soucy D (D)A PBM shall not require accreditation of providers other thanrequirements set forth by the New Hampshire pharmacy board orother state or federal entity. Prohibits a health carrier or PBMrequiring accreditation, credentialing, or licensing of a provider otherthan by the New Hampshire pharmacy board or other state or federalregulatory body or must not exclude a provider from dispensing anynew drug product for which the provider meets the manufacturer'sdispensing guidelines, or otherwise discriminate against a provider.NH H 17462018Pharmacy Benefit ManagersStatus: Enacted - Act No. 2018-92Date of Last Action:* 05/25/2018 - EnactedAuthor: Hennessey (R)Prohibits PBM from requiring accreditation, credentialing, or licensingof providers other than by the New Hampshire Pharmacy Board orother state or federal entity. Repeals section relative to prohibitingPBMs to require providers to obtain certain accreditation.NH H 17912018Pharmacy DisclosuresStatus: Enacted - Act No. 2018-164Date of Last Action:* 06/07/2018 - EnactedAuthor: Butler (D)This enacted bill affects PBMs and gag clauses, biosimilar substitution,and drug labeling. It establishes that a contract between an insurancecarrier or PBM and a contracted pharmacy shall not contain aprovision prohibiting the pharmacist from providing price informationto an insured. A pharmacist may substitute a biological product only ifit has been licensed by the federal FDA as an interchangeablebiological product for the prescribed biological product and notify thepatient. The prescriber may indicate that substitution is notauthorized by specifying on the prescription "medically necessary" ona paper prescription, or uses electronic indications when transmittedelectronically, or gives instructions when transmitted orally that thebiological product prescribed is medically necessary. Within 3 businessdays the dispensing pharmacist or the pharmacist's designee shallmake an electronic entry of the specific product provided to thepatient, including the manufacturer. The communication shall beconveyed by making an entry that is electronically accessible to theprescriber.
South CarolinaSC H 5038 2018Pharmacy Benefit Manager DutiesStatus: Enacted - Act No. 177Date of Last Action:* 05/03/2018 - EnactedAuthor: Atwater (R)Associated Bills: SC H 5044; SC S 815Establishes prohibited acts for a PBM. Provides that a PBM may notprohibit a pharmacist or pharmacy from providing an insuredinformation on the amount of the insured's cost share for aprescription drug, from offering and providing direct and limiteddelivery services to an insured as an ancillary service of the pharmacy,charge or collect a copayment, hold a pharmacist or pharmacyresponsible for certain fees, or retaliate for exercising rights.South DakotaSD S 141 2018Pharmacy Benefits ManagersStatus: Enacted - Act No. 281Date of Last Action:* 02/27/2018 - EnactedAuthor: Solano (R)Establishes certain provisions regarding pharmacy benefitsmanagement. The act prohibits PBMs from "prohibiting a pharmacistor pharmacy for providing cost-sharing information on the amountthat a covered individual may pay for a particular prescription drug bya pharmacist or pharmacy." It also prohibits PBMs from "penalizing apharmacist or pharmacy for providing cost-sharing information on theamount that a covered individual may pay for a particular prescriptiondrug by a pharmacist or pharmacy."TennesseeTN H 9012018Opioid Prescriptions for EnrolleesStatus: Enacted - Act No. 864Date of Last Action:* 05/03/2018 - EnactedAuthor: Kumar (R)Associated Bills: TN S 1227Requires the Bureau of TennCare promulgate rules for safe coverageof opioid prescriptions by enrollees and for prior authorizationrequirements for opioid prescriptions for enrollees in certaincircumstances. Requires exemptions from prior authorization forenrollees with certain medical conditions.TN S 18522018Pharmacy Benefits ManagerStatus: Enacted - Act No. 838Date of Last Action:* 04/27/2018 - EnactedAuthor: Haile (R)Associated Bills: TN H 1857Relates to the licensing of pharmacy benefits managers. Requires anyperson operating in this state as a pharmacy benefits manager becertified by the department of commerce and insurance prior tooperating. Sets licensing fees, renewal fees and violation fines.TN S 23622018Health CareStatus: Enacted - Act No. 1015Date of Last Action:* 05/21/2018 - EnactedAuthor: Crowe (R)Revises provisions relating to hospital health care and gag clauses.Requires the Department of Health to include a determination of ahospital's compliance with reporting requirements in its annualinspections. A pharmacy or pharmacist has the right to provide aninsured information regarding the amount of the insured's cost sharefor a prescription drug and shall not be penalized for doing such.
UtahUT H 552018Veterans and Military AffairsStatus: Enacted - Act No. 39Date of Last Action:* 03/15/2018 - EnactedAuthor: Ray (R)Creates regulations for the auditing of pharmacies.UT S 2082018Amends the Pharmacy Practice ActStatus: Enacted - Act No. 305Date of Last Action:* 03/19/2018 - EnactedAuthor: Vickers (R)Amends the Pharmacy Practice Act. Requires a pharmacy serviceentity that uses direct or indirect remuneration to reportreimbursements to pharmacies or the pharmacy servicesadministration organization. Prohibits a pharmacy benefits manageror coordinator from preventing a pharmacist from disclosing costinformation to a patient, also known as gag clauses.VermontVT S 922018Interchangeable Biological ProductsStatus: Enacted - Act No. 193Date of Last Action:* 05/30/2018 - EnactedAuthor: Lyons (D)Revises provisions relating to prescription drug price transparency andcost containment. 1) Requires prior authorization to refill aprescription with a drug or biological product different than theoriginally filled prescription and requires electronic notifications afterdispensing biological products. Requires a pharmacist to select thelowest priced drug or interchangeable biological product. 2) Expandsthe provisions of Vermont's 2016 Rx transparency law to require theDepartment of Vermont Health Access and health insurers with morethan 5,000 covered lives to create lists of 10 prescription drugs forwhich the payer's net cost has increased by 50 percent or more overthe past five years or 15 percent annually. The Office of the AttorneyGeneral will identify 15 drugs for which the drugs' manufacturersmust provide a justification for the price increase or increases. Eachmanufacturer must also provide a separate version of its justificationthat will be made public. 3) It prohibits PBMs from prohibiting orpenalizing a pharmacy or pharmacist for providing information to aninsured about a cost-sharing amount for a prescription drug,disclosing to an insured the cash price of a prescription drug, or sellinga lower-cost drug to an insured if one is available. 4) Also creates aworking group to examine prescription drug pricing throughout thesupply chain, to identify opportunities for savings, and more pricetransparency, and to provide findings and recommendations to theHouse Committee on Health Care and the Senate Committee onHealth and Welfare.VirginiaVA S 933 2018Prescription Drug Copayment LimitsStatus: Enacted - Act No. 602Date of Last Action:* 03/30/2018 - EnactedAuthor: Saslaw (D)Associated Bills: VA H 1177Relates to health insurance copayments and transparency forprescription drugs. Prohibits any clawback contract between a healthcarrier or its pharmacy benefits manager and a pharmacy orpharmacist from containing a provision that requires an enrollee tomake a copayment for a covered prescription drug in an amount thatexceeds the lesser of the applicable copayment for the prescriptiondrug or the cash price.
VA H 11772018Pharmacists and Pharmacy PracticesStatus: Enacted - Act No. 245Date of Last Action:* 03/09/2018 - EnactedAuthor: Pillion (R)Associated Bills: VA S 933 – IdenticalRelates to pharmacy practices, perm
errors by a pharmacy. Alaska AK S 37 2018 Board of Pharmacy Inspection and Licensing Status: Enacted - Act No. 2018-66 Date of Last Action:* 07/24/2018 - Enacted Author: Giessel (R) To fulfill its responsibilities, the board has the powers necessary for implementation and enforcement of this chapter, including the power
