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PBM accountability bill draws wide debate: sponsors seek transparency, industry warns of higher premiums and ERISA conflicts
Summary
SB 478 would ban spread pricing, delink PBM compensation from list price and require confidential plan-level reporting; patient groups and some industry representatives supported the reforms for affordability and clarity, while insurers, PBMs and hospitals warned of legal, operational and fiscal risks and asked for technical changes.
Senate Bill 478 would require significant changes to pharmacy-benefit management practices in New Hampshire: prohibit spread pricing (PBM charging plans more than reimbursing pharmacies), delink PBM compensation from drug list price and rebate magnitude, require confidential reporting to the insurance department, strengthen maximum-allowable-cost (MAC) transparency and protect 340B nondiscrimination.
Sponsor Senator Tim McHugh framed the effort as restoring transparency and directing savings to patients:…
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