SCS/SBs 978 & 1035 - Under this act, no health carrier or pharmacy benefits manager (PBM) shall discriminate against a federally-qualified health center (FQHC) or a specified pharmacy, as such term is defined in the act, by: • Reimbursing a FQHC or specified pharmacy for a quantity of a 340B drug, as defined in the act, in an amount less than the carrier or PBM would pay to any other similarly situated pharmacy for such quantity of the drug on the basis that the entity or pharmacy is a FQHC or specified pharmacy, or that the entity or pharmacy dispenses 340B drugs. (Section 376.414.2(1));
• Imposing any terms or conditions on FQHCs or specified pharmacies which differ from the terms or conditions applicable to other similarly situated pharmacies on the basis that the entity or pharmacy is a FQHC or specified pharmacy or dispenses 340B drugs, including but not limited to certain terms and conditions described in the act. (Section 376.414.2(2));
• Interfering with an individual's choice to receive a 340B drug from a FQHC or specified pharmacy. (Section 376.414.2(3));
• Requiring a FQHC or specified pharmacy to identify 340B drugs, either directly or through a third party. (Section 376.414.2(4)); or
• Refusing to contract with a FQHC or specified pharmacy for reasons other than those that apply equally to entities or pharmacies that are not FQHCs or specified pharmacies, or on the basis that the entity or pharmacy is a FQHC or specified pharmacy, or on the basis that the entity or pharmacy is described as a FQHC under provisions of federal law. (Section 376.414.2(5)).
The Director of the Department of Commerce and Insurance shall impose a civil penalty on any PBM violating certain provisions of the act, not to exceed $5,000 per violation per day. (Section 376.414.3).
This act is similar to the truly agreed to and finally passed SS/SB 751 (2024), SB 1035 (2024), provisions in SB 1213 (2024), HB 1977 (2024), provisions in HCS/HB 2267 (2024), SB 426 (2023), provisions in HCS/HB 198 (2023), provisions in SB 426 (2023), HB 197 (2023), provisions in SB 921 (2022), provisions in HCS/HB 1677 (2022), provisions in SB 1129 (2022), and provisions in HB 2305 (2022).
ERIC VANDER WEERD