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Assembly panel hears joint HCAI/DMHC plan to license PBMs and require drug‑supply reporting
Summary
The Department of Managed Health Care and HCAI presented a joint May Revision proposal to require licensure of pharmacy benefit managers contracting with California insurers and to mandate PBM data reporting to HCAI; the DMHC would gain audit and enforcement authority and both agencies would seek positions to implement the new requirements.
The Department of Managed Health Care (DMHC) and the Department of Health Care Access and Information (HCAI) told the Assembly Budget Subcommittee No. 1 on Health that the May Revision proposes replacing current pharmacy benefit manager (PBM) registration with a licensure requirement and expanding data reporting to HCAI's Health Care Payments Data (HPD) program.
DMHC Director Mary Watanabe summarized the proposal: PBMs that contract with a DMHC‑licensed health plan or a California Department of Insurance‑regulated insurer would need to obtain a DMHC license, submit quarterly financial statements and other information, be subject to DMHC audits for compliance, and pay annual assessments to…
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