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2018 Regular Session



Health Insurance and Pharmacy Benefits Managers - Reimbursement for and Provision of Pharmacy Services

Sponsored by:

Senator Mathias


In the Senate - Unfavorable Report by Finance; Withdrawn

Synopsis:Authorizing a pharmacist or a pharmacy to decline to dispense a prescription drug or provide a pharmacy service to a member if the amount reimbursed by an insurer, a nonprofit health service plan, or a health maintenance organization is less than the acquisition cost; prohibiting a pharmacy benefits manager from reimbursing a pharmacy or pharmacist for a product or a pharmacy service in an amount less than the amount the pharmacy benefits manager reimburses itself for the same product or pharmacy service; applying the Act; etc.
Analysis:Fiscal and Policy Note
All Sponsors:Senator Mathias
Additional Facts:Cross-filed with: HB1290
Introduced in a prior session as: SB1055 Session: 2017 Regular Session
Bill File Type: Regular
Effective Date(s): October 1, 2018
Broad Subject(s):Insurance - Health
Narrow Subject(s):Consumer Protection -see also- Unfair Trade Practices
Drugs -see also- Controlled Dangerous Sub; Substance Abuse
Health Insurance -see also- HMOS; Managed Care Organizations
Health Maintenance Organizations -see also- Manage Care Orgs
Nonprofit Organizations
Pharmacy Benefits Managers
Pharmacists and Pharmacies
Reimbursement Rates
Statutes:Article - Insurance
(15-1012, 15-1632)

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March 7, 2018 9:43 A.M.