Committee adopts broader amendment to SB316 to add PBM oversight, copay accumulator language and contract review authority

Senate Bill 316 was the subject of extensive work‑session discussion and amendments. Senator Wynne introduced a draft amendment that deletes a contested section, adds new prohibitions on spread pricing, and creates administrative review and enforcement authority over pharmacy benefit managers (PBMs) and PBM‑health plan contracts.

Sponsor-led changes would require the insurance commissioner, in coordination with Nevada Medicaid, to review and approve PBM‑health plan contracts before execution to ensure compliance with statutory limits on administrative fees and to prevent unfair pricing practices. The amendment also would allow the commissioner to charge an operations fee on PBMs and require PBMs to employ value‑based purchasing arrangements for high‑cost drugs to enable shared savings with the state. The sponsor said the changes are intended to target unfair business practices that can raise drug costs for payers and patients.

Senator Wynne also asked to add back co‑pay accumulator language previously included in an earlier draft and to remove dental‑plan organizations from a section that did not apply to them. LCB fiscal staff said there were no fiscal changes to the division of insurance costs beyond those already discussed. The committee rescinded an earlier amendment action, heard additional explanation of the proposed changes, then voted to adopt the sponsor’s amendment and pass the bill as amended.

Votes at work session: Committee rescinded the prior amend-and-do-pass action and approved the sponsor’s comprehensive amendment; the amend-and-do-pass motion carried.