SB 1797 prohibits manufacturers and distributors from engaging in "price gouging" on specific essential off-patent or generic drugs, defined as drugs without patent protection, listed by WHO or the U.S. as essential, and sold by few manufacturers. It directly affects drug companies selling these medications in Arizona, requiring them to justify price increases exceeding 50% within a year or exceeding $80 for basic treatment (e.g., 30-day supply). The state’s Medicaid program can trigger investigations for such increases, prompting manufacturers to submit cost breakdowns within 45 days. If violations are confirmed, the attorney general can seek court orders for restitution, injunctions, or civil penalties up to $10,000 per violation. The bill focuses on transparency and accountability for price hikes impacting affordability, not on altering drug approval or insurance coverage.
HB 4124 requires pharmacy benefit managers (PBMs) in Arizona to reimburse local pharmacies at or above the actual acquisition cost of drugs, not below. It mandates PBMs to use specific reimbursement formulas based on national drug pricing averages, limits claim payment errors to a 2% rate, and creates a 15-day appeal process for pharmacies to challenge underpayments. The bill directly affects community pharmacies (with fewer than 10 locations) and PBMs by ensuring fair reimbursement, requiring transparent rebate disclosures, and obligating PBMs to pass manufacturer rebates to health plans for lower costs or broader coverage. Key provisions include standardized payment calculations, mandatory error correction, and annual compliance certifications to the state department.
This Arizona bill prohibits pharmacy benefit managers (PBMs) from steering patients to use their affiliated pharmacies through tactics like data mining, financial incentives, or retaliation. It bans PBMs from offering different copays, rewards, or penalties to influence patients toward their partner pharmacies and requires transparency about rebates and fees. PBMs must annually report detailed data on rebates, administrative fees, and pharmacy reimbursements to the state department. The law directly affects PBMs, patients who may face steering, and competing pharmacies seeking prescriptions.
SB 1678 requires assisted living centers and homes in Arizona to provide emergency responders with a standardized written document when contacting them for a resident. This document must include critical information like the resident's medications, allergies, primary care physician details, health conditions, pharmacy contact, health insurance authorization, and advance directives. The bill also mandates that hospitals coordinate with receiving assisted living facilities by providing detailed discharge plans, including medical assessments, medication instructions, and follow-up care recommendations. These provisions directly affect assisted living facilities, emergency responders, hospitals, and residents by standardizing communication during medical emergencies and patient transfers. The goal is to improve care coordination and safety during transitions between facilities and emergency services.
SB 1545 prohibits pharmacy benefit managers (PBMs) from owning or holding retail pharmacy permits in Arizona. It requires the state board to revoke or not renew permits held by entities violating this rule, but allows temporary "limited service" permits for pharmacies dispensing rare or hard-to-find medications to ensure patient access. Pharmacies receiving notice of potential permit revocation must inform affected patients and providers 60 days before January 1, 2027. The bill creates specific processes for requesting limited service permits, notifying the board about unavailable medications, and includes exceptions for pharmacy employers that own PBMs or exclusively serve their own employees.
This Arizona bill (SB 1404) amends workers' compensation rules to give injured workers more control over their medical care. It allows injured workers to choose their medical provider, pharmacy, and ancillary services (like lab tests and medical equipment) without employer or insurer interference. The bill also requires translation services for language needs (using certified translators when possible), covers travel costs over 25 miles for medical appointments, and sets clear timelines for benefit payments (first payment within 21 days, then weekly or monthly). These changes directly affect injured workers seeking workers' compensation benefits in Arizona.
SB 1188 automatically aligns Arizona's controlled substance scheduling with federal classifications for FDA-approved medications (excluding Schedule I drugs), meaning Arizona will adopt the same schedules as the U.S. Drug Enforcement Administration without requiring separate state action. This allows healthcare providers in Arizona to prescribe these medications as permitted under federal law, eliminating the need for the state pharmacy board to reclassify them. The bill directly affects the Arizona State Board of Pharmacy and medical professionals who prescribe or dispense controlled substances by simplifying scheduling requirements. It applies only to drugs approved by the FDA and scheduled by the federal government (other than Schedule I), ensuring consistency with federal regulations.
HB 2725 prevents AHCCCS (Arizona's Medicaid program) from requiring patients to switch from non-opioid pain medications to opioids when a doctor prescribes a non-opioid for chronic or acute pain. It also prohibits stricter coverage rules - like more difficult prior authorization or step therapy - for non-opioid pain drugs compared to opioid alternatives. The bill directly affects AHCCCS members prescribed pain medication and their healthcare providers. Key provisions mandate equal treatment in coverage policies for clinically appropriate non-opioid and opioid pain drugs. This bill is pending in the Arizona legislature after its first reading in January 2026.
This bill requires pharmacy benefit managers (PBMs) to reimburse independent pharmacies at actual cost for prescription drugs or devices, not below that cost. It mandates a minimum professional dispensing fee and creates a 7-business-day appeal process for pharmacies challenging low reimbursements. If a pharmacy wins an appeal, the PBM must adjust payments retroactively, apply the change to similar pharmacies, and allow rebilling. The law applies to new contracts entered after December 31, 2026.
SB 1225 requires pharmacy benefit managers (PBMs) and third-party payors to calculate patient cost-sharing (like copays or deductibles) at the point of sale using a price reduced by at least 100% of all rebates received for a prescription drug. This means patients must pay the lowest possible price after all rebates are applied, and PBMs cannot keep any portion of rebates as revenue. The law directly affects patients enrolled in health plans covered by these PBMs, ensuring they benefit fully from negotiated drug discounts. It applies to new or renewed health plans after December 31, 2026.
