Healthcare (Prescription Drugs)

HB 740 revises laws affecting pharmacies, pharmacy benefit managers (PBMs), and other entities involved in prescription drug dispensing and reimbursement. The bill establishes new restrictions on how PBMs can audit pharmacies and recoup funds, such as prohibiting recoupment for clerical errors without actual financial harm and banning the use of extrapolation in calculations. It also updates regulations for Maximum Allowable Cost (MAC) lists and reference pricing, requiring PBMs to ensure drugs on MAC lists are available and to frequently update and disclose pricing information to pharmacies.

Senate Bill 456 revises professions and occupations laws related to the dispensing of drugs by medical practitioners. It allows health care staff, other than the practitioner, to convey dispensed drugs to patients at the practitioner's office. For this to happen, the practitioner must first prepare and seal the drugs with two forms of identification on the package. The staff member is then required to verify the patient's identity before handing over the medication. The bill maintains other requirements for practitioners who dispense drugs, such as registration with the board of pharmacy.

HB 399 revises prior authorization laws for health insurance issuers, aiming to simplify access to certain prescription drugs for covered individuals. The bill prohibits prior authorization for oral and inhaled generic prescription drugs, inhaled medications for asthma or chronic lung diseases, and insulin for diabetes patients. It also restricts prior authorization for generic drugs used consistently for six months and for dosage adjustments within approved limits. If an insurer makes an adverse determination for a prescription drug, the decision must be made by a specialist physician, and the insurer must provide a list of covered therapeutic alternatives.

HB 794 revises general pharmacy laws, impacting pharmacies, pharmacy technicians, and clinical pharmacist practitioners. The bill updates and clarifies definitions, removes the utilization plan requirement for in-state and mail-order pharmacies, and mandates an endorsement for clinical pharmacist practitioners. It also eliminates outdated notification practices for biosimilar drug selection and generic drug signage requirements. Additionally, the bill clarifies pharmacy wholesale distribution licenses and the powers of the Board of Pharmacy, and adjusts provisions for insurance plans regarding out-of-state mail-order pharmacies.

SB 317 prohibits health insurance companies from requiring prior authorization for psychiatric prescription drugs that are officially designated as being in shortage. The list of these drugs will be updated quarterly, based on the U.S. Food and Drug Administration's official shortage list. This aims to ensure covered persons can access necessary psychiatric medications without delays due to prior authorization when supplies are limited. Additionally, the bill prevents manufacturers of these shortage drugs from engaging in predatory pricing or marketing practices.