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Committee advances Senate Bill 140 with amendments targeting PBM practices, pharmacy reimbursement and network adequacy
Summary
A committee unanimously approved an amended Senate Bill 140 that removes vertical-integration language but sets pharmacy network standards, bans certain clawbacks, requires reimbursement parity, and guarantees minimum reimbursements tied to NADAC and a Medicaid dispensing fee for some pharmacies.
A House committee voted 13-0 to pass an amended version of Senate Bill 140 that changes how pharmacies are reimbursed, limits certain pharmacy benefit manager (PBM) practices and requires network adequacy for in-person pharmacy access.
Representative Layman, who presented amendments adopted in committee, said the bill removes the Senate's vertical-integration divestiture language and instead requires plans to offer in-person pharmacies within 30 miles of a covered person's home where such pharmacies are available. The amendment also requires plans to permit any pharmacy willing to accept contract…
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