SB2754 - Pharmacy benefit managers; set certain requirements related thereto, including claim administration and reimbursements.

1 Co-Sponsor

An Act To Amend Section 73-21-153, Mississippi Code Of 1972, To Define New Terms And Revise The Definitions Of Existing Terms Under The Pharmacy Benefit Prompt Pay Act; To Amend Section 73-21-155, Mississippi Code Of 1972, To Prohibit Contracts That Violate Public Policy; To Amend Section 73-21-156, Mississippi Code Of 1972, To Require Pharmacy Benefit Managers To Provide A Reasonable Administrative Appeal Procedure To Allow Pharmacies To Challenge A Reimbursement For A Specific Drug Or Drugs As Being Below The Reimbursement Rate Required By The Preceding Provision; To Provide That If The Appeal Is Upheld, The Pharmacy Benefit Manager Shall Make The Change In The Payment To The Required Reimbursement Rate; To Amend Section 73-21-157, Mississippi Code Of 1972, To Require A Pharmacy Services Administrative Organization To Provide To A Pharmacy Or Pharmacist A Copy Of Any Contract Entered Into On Behalf Of The Pharmacy Or Pharmacist By The Pharmacy Services Administrative Organization; To Create New Section 73-21-158, Mississippi Code Of 1972, To Prohibit Pharmacy Benefit Managers From Charging A Plan Sponsor More For A Prescription Drug Than The Net Amount It Pays A Pharmacy For The Prescription Drug; To Prohibit A Pharmacy Benefit Manager Or Third-party Payer From Charging A Patient To Pay A Copayment That Exceeds The Total Reimbursement Paid By The Pharmacy Benefit Manager To The Pharmacy; To Amend Section 73-21-161, Mississippi Code Of 1972, To Prohibit A Pharmacy Benefit Manager Or Pharmacy Benefit Manager Affiliates From Ordering A Patient To Use An Affiliate Pharmacy Or The Affiliate Pharmacy Of Another Pharmacy Benefit Manager, Or Offering Or Implementing Plan Designs That Penalize A Patient When A Patient Chooses Not To Use An Affiliate Pharmacy Or The Affiliate Pharmacy Of Another Pharmacy Benefit Manager, Or Interfering With The Patient's Right To Choose The Patient's Pharmacy Or Provider Of Choice; To Create New Section 73-21-162, Mississippi Code Of 1972, To Prohibit Pharmacy Benefit Managers And Pharmacy Benefit Manager Affiliates From Penalizing Or Retaliating Against A Pharmacist, Pharmacy Or Pharmacy Employee For Exercising Any Rights Under This Act, Initiating Any Judicial Or Regulatory Actions, Or Appearing Before Any Governmental Agency, Legislative Member Or Body Or Any Judicial Authority; To Amend Section 73-21-163, Mississippi Code Of 1972, To Authorize The Board Of Pharmacy, For The Purposes Of Conducting Investigations, To Conduct Examinations Of Pharmacy Benefit Managers And To Issue Subpoenas To Obtain Documents Or Records That It Deems Relevant To The Investigation; And For Related Purposes.