Requires the Legislative Reference Bureau to conduct a study on best practices for the regulation of pharmacy benefit managers and reduction in prescription drug costs for health insurance plan beneficiaries. Requires a report to the Legislature. Effective 12/31/2050. (HD1)
Establishes requirements for the clinical review criteria and clinical practical guidelines used to establish step therapy protocols. Provides a process for a patient to request an exception to using step therapy protocols. Establishes insurance coverage requirements relating to the use of step therapy protocols and standards to appeal an adverse step therapy exception determination.
Beginning 1/1/2027, requires all health insurers, mutual benefit societies, and health maintenance organizations in the State, including Medicaid managed care programs, to cover the cost of continuous glucose monitors and related supplies under certain conditions. Allows the Department of Health and Department of Human Services to accept and expend funds from public and private sources to support the expansion of access to continuous glucose monitors. (CD1)
Prohibits drug manufacturers and wholesale distributors from restricting or denying access for pharmacies contracted with 340B covered entities to purchase 340B drugs at a discounted price under the federal 340B Drug Pricing Program. Imposes civil penalties for engaging in unfair or deceptive acts or practices in the conduct of any trade or commerce.
Authorizes a registered pharmacist under contract with a covered entity for purposes of the federal 340B Drug Pricing Program to supervise the filling or receipt of a prescription via telehealth in certain circumstances. Effective 7/1/3000. (HD1)
Beginning 1/1/2027, requires health insurers, mutual benefit societies, and health maintenance organizations that issue policies, contracts, plans, or agreements that provide prescription drug coverage to provide coverage for at least one generic opioid antagonist and device.
Prohibits discrimination against a pharmacy or pharmacist with respect to participation, referral, reimbursement of a covered service, or indemnification. Establishes beneficiary cost sharing and deductible requirements for prescription drugs. Establishes minimum rates for which pharmacy benefit managers are to reimburse pharmacies for dispensing prescription drugs. For prescription drug benefit plans executed, amended, adjusted, or renewed on or after 7/1/2027, requires a pharmacy benefit manager to use pass-through pricing, or may alternatively use spread pricing if any savings realized by the pharmacy benefit manager are passed on.
Establishes requirements for the clinical review criteria and clinical practical guidelines used to establish step therapy protocols. Provides a process for a patient to request an exception to using step therapy protocols. Establishes insurance coverage requirements relating to the use of step therapy protocols and standards to appeal an adverse step therapy exception determination.
Authorizes a school to maintain a stock supply of bronchodilators to be administered under certain conditions. Authorizes certain employees of a school and department personnel to administer certain medication in emergency situations, under certain conditions. Amends prescription drug labeling requirements to include certain information related to a school, if applicable. Effective 7/1/3000. (HD1)
Authorizes a registered pharmacist under contract with a covered entity for purposes of the federal 340B Drug Pricing Program to supervise via telehealth the filling or receipt of a prescription in certain circumstances.
