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House Insurance Committee approves substitute to expand pharmacy protections, PBM transparency
Summary
The House Insurance Committee approved a substitute for House Bill 192 that adds protections for community pharmacies, expands oversight to auditing entities, and requires additional reporting from pharmacy benefit managers.
The House Insurance Committee approved a substitute version of House Bill 192 that adds protections for community pharmacies and increases transparency for pharmacy benefit managers (PBMs). Representative Barhorst moved the substitute and the committee approved it without objection.
The substitute broadens oversight beyond health insurers to include auditing entities, adds definitions for prior authorization and unanticipated out-of-network care, and requires PBMs to submit quarterly drug-claim reports in both machine-readable and plain-language formats. Representative Barhorst said the changes “add additional protections for community pharmacies and increase transparency in the operations of pharmacy benefit managers, expands the oversight beyond health insurers to include auditing entities, ensuring all parties involved in pharmacy services are held accountable, added definitions prior to added definition for prior authorization requirement and unanticipated out of network care, clarifies insurance processes and improve patient protections.”
The substitute also strengthens anti-discrimination provisions by prohibiting PBMs from preferentially treating affiliated or owned pharmacies through cost-sharing structures, contract terms, or mail-order requirements. Sponsors described the reporting requirement as aligning state practice with new federal reporting standards and intended to make PBM data more accessible to regulators and affected pharmacies.
Committee members did not request formal amendments on the floor and approved the substitute by voice, with no objections recorded. The committee designated Representative Coughley as acting secretary for the meeting.
The substitute advances HB 192 to the committee record; no additional committee directions or formal secondary actions were recorded during the floor discussion.
