Bill Text: IA SF2357 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: A bill for an act relating to the regulation of pharmacy benefits managers.(Formerly SSB 3079.)
Spectrum: Committee Bill
Status: (Introduced - Dead) 2024-04-17 - Withdrawn. S.J. 858. [SF2357 Detail]
Download: Iowa-2023-SF2357-Introduced.html
Senate
File
2357
-
Introduced
SENATE
FILE
2357
BY
COMMITTEE
ON
COMMERCE
(SUCCESSOR
TO
SSB
3079)
(COMPANION
TO
HF
2099
BY
COMMITTEE
ON
COMMERCE)
A
BILL
FOR
An
Act
relating
to
the
regulation
of
pharmacy
benefits
1
managers.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
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2357
Section
1.
Section
510B.1,
subsection
10,
paragraph
b,
Code
1
2024,
is
amended
to
read
as
follows:
2
b.
National
average
drug
acquisition
cost.
3
Sec.
2.
Section
510B.4,
subsection
1,
Code
2024,
is
amended
4
to
read
as
follows:
5
1.
A
pharmacy
benefits
manager
shall
exercise
good
faith
6
and
fair
dealing
in
the
performance
of
the
pharmacy
benefits
7
manager’s
contractual
obligations
toward
a
third-party
payor
8
or
a
pharmacy
.
9
Sec.
3.
NEW
SECTION
.
510B.4A
Retaliation
prohibited.
10
A
pharmacy
benefits
manager
shall
not
retaliate
against
11
a
pharmacy
based
on
the
pharmacy’s
exercise
of
any
right
or
12
remedy
under
this
chapter,
including
but
not
limited
to
filing
13
a
complaint
with
the
commissioner
or
cooperating
with
the
14
commissioner
pursuant
to
the
commissioner’s
authority
under
15
this
chapter.
Retaliation
prohibited
by
this
section
shall
16
include
but
is
not
limited
to
all
of
the
following:
17
1.
Terminating
or
refusing
to
renew
a
contract
with
the
18
pharmacy.
19
2.
Subjecting
the
pharmacy
to
increased
audits.
20
3.
Withholding
or
failing
to
promptly
pay
the
pharmacy
any
21
money
owed
by
the
pharmacy
benefits
manager
to
the
pharmacy.
22
Sec.
4.
Section
510B.7,
Code
2024,
is
amended
to
read
as
23
follows:
24
510B.7
Pharmacy
networks
fees
.
25
A
pharmacy
benefits
manager
shall
not
assess,
charge,
or
26
collect
any
form
of
remuneration
that
passes
from
a
pharmacy
27
or
a
pharmacist
in
a
pharmacy
network
to
the
pharmacy
benefits
28
manager
including
but
not
limited
to
claim
processing
fees,
29
performance-based
fees,
network
participation
fees,
or
30
accreditation
fees.
31
Sec.
5.
Section
510B.8A,
subsection
2,
paragraph
b,
Code
32
2024,
is
amended
to
read
as
follows:
33
b.
Update
the
maximum
allowable
cost
list
within
seven
34
calendar
days
from
the
date
of
an
increase
of
ten
percent
or
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2357
more
in
the
pharmacy
national
average
drug
acquisition
cost
1
of
a
prescription
drug
on
the
list
by
one
or
more
wholesale
2
distributors
doing
business
in
the
state
.
3
Sec.
6.
Section
510C.2,
subsection
2,
paragraph
a,
4
unnumbered
paragraph
1,
Code
2024,
is
amended
to
read
as
5
follows:
6
A
pharmacy
benefits
manager
shall
provide
the
information
7
pursuant
to
subsection
1
to
the
commissioner
in
a
format
8
approved
by
the
commissioner
that
does
not
directly
or
9
indirectly
publicly
disclose
any
of
the
following:
10
EXPLANATION
11
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
12
the
explanation’s
substance
by
the
members
of
the
general
assembly.
13
This
bill
relates
to
the
regulation
of
pharmacy
benefits
14
managers
(PBMs).
Under
current
law,
a
PBM
owes
a
duty
of
good
15
faith
and
fair
dealing
to
third-party
payors.
The
bill
expands
16
that
duty
to
pharmacies.
17
The
bill
prohibits
retaliation
by
a
PBM
against
a
pharmacy
18
based
on
the
pharmacy’s
exercise
of
any
right
or
remedy,
or
on
19
the
pharmacy’s
cooperation
with
the
commissioner.
Prohibited
20
retaliation
includes
terminating
or
refusing
to
renew
a
21
contract
with
a
pharmacy,
subjecting
a
pharmacy
to
increased
22
audits,
or
withholding
or
failing
to
promptly
pay
the
pharmacy
23
any
money
owed
by
the
PBM.
24
Current
law
prohibits
a
PBM
from
assessing,
charging,
25
or
collecting
any
form
of
remuneration
that
passes
from
a
26
pharmacist
in
a
pharmacy
network
to
the
PBM.
Under
the
bill,
27
a
PBM
is
prohibited
from
assessing,
charging,
or
collecting
28
any
form
of
remuneration
that
passes
from
any
pharmacist,
29
regardless
of
whether
the
pharmacist
is
in
a
pharmacy
network.
30
Under
current
law,
for
each
maximum
allowable
cost
list
that
31
a
PBM
uses,
a
PBM
shall
update
the
maximum
allowable
cost
list
32
within
seven
days
from
the
date
of
an
increase
of
10
percent
or
33
more
in
the
pharmacy
acquisition
cost
of
a
prescription
drug
34
on
the
list.
Under
the
bill,
for
each
maximum
allowable
cost
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list
that
a
PBM
uses,
a
PBM
shall
update
the
maximum
allowable
1
cost
list
within
seven
days
from
the
date
of
an
increase
of
10
2
percent
or
more
in
the
national
average
drug
acquisition
cost
3
of
a
prescription
drug
on
the
list.
4
The
bill
requires
that
the
annual
report
provided
by
a
PBM
5
to
the
commissioner
of
insurance
regarding
prescription
drug
6
benefits
provided
to
covered
persons
of
each
third-party
payor
7
with
whom
the
PBM
has
contracted
during
the
prior
calendar
year
8
be
in
a
format
that
does
not
publicly
disclose
the
identity
of
9
a
specific
third-party
payor,
the
price
charged
by
a
specific
10
pharmaceutical
manufacturer
for
prescription
drugs,
or
the
11
amount
of
rebates
provided
for
prescription
drugs.
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