Bill
SB 5213
Overview: SB 5213, Concerning pharmacy benefit managers, effective date 6/6/2024, introduced on January 09, 2025.Purpose and Intent: The bill aims to regulate the practices of phar
Overview: SB 5213, Concerning pharmacy benefit managers, effective date 6/6/2024*, introduced on January 09, 2025.
Purpose and Intent: The bill aims to regulate the practices of pharmacy benefit managers (PBMs) in order to increase transparency and protect consumers.
Key Provisions:
- Requires PBMs to obtain a license from the state to operate.
- Prohibits PBMs from engaging in certain practices, such as clawbacks, spread pricing, and requiring the use of affiliated pharmacies.
- Mandates PBMs to provide detailed reporting on their pricing and reimbursement practices.
- Establishes an appeals process for pharmacies to challenge PBM reimbursement rates.
Affected Parties and Impacts:
- Consumers who use prescription drugs, as the bill aims to lower drug prices and increase transparency.
- Pharmacies, which will have more recourse to challenge PBM reimbursement rates.
- Pharmacy benefit managers, who will face new licensing and reporting requirements.
Procedural and Timeline Considerations:
The bill has been passed by the legislature and is awaiting the governor's signature to become effective on June 6, 2024.
Compiled from official sources — confirm details with the bill’s official record.
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