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Bill

A 9045

Relates to reimbursements practices of pharmacy benefit managers

2025 Regular Session Introduced by Anna Kelles

Bill A 9045 reforms pharmacy benefit managers' practices, ensuring fair reimbursements and transparent pricing, benefiting pharmacies and consumers alike.

REFERRED TO HEALTH
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Bill Summary · A 9045

Summary of Bill A 9045

Bill Information

  • Bill Number: A 9045
  • Title: Relates to reimbursement practices of pharmacy benefit managers
  • Status: Referred to Health Committee
  • Introduced On: September 5, 2025
  • Classification: Bill

Purpose and Intent

Bill A 9045 aims to reform the reimbursement practices of pharmacy benefit managers (PBMs) in order to enhance transparency and fairness in the pharmaceutical supply chain. The bill seeks to address concerns regarding the pricing and reimbursement processes that PBMs use, which can significantly impact both pharmacies and consumers.

Key Provisions

While the specific text of the bill is not provided, the following key provisions are typically expected in legislation addressing PBM practices:

  1. Transparency Requirements:

    • Mandates that PBMs disclose their reimbursement rates to pharmacies and the criteria used to determine these rates.
    • Requires PBMs to provide clear information on any fees or discounts that may affect the final reimbursement amount.

  2. Fair Reimbursement Practices:

    • Establishes guidelines to ensure that pharmacies are reimbursed fairly for the medications they dispense.
    • Prohibits PBMs from engaging in practices that could lead to under-reimbursement or unfair competition against independent pharmacies.

  3. Consumer Protections:

    • Aims to protect consumers from unexpected out-of-pocket costs by ensuring that pricing information is readily available and understandable.
    • May include provisions to limit the ability of PBMs to impose high co-pays or deductibles that disproportionately affect patients.

Affected Parties

  • Pharmacies: Independent and chain pharmacies will be directly impacted by changes in reimbursement practices, potentially leading to improved financial stability.
  • Consumers: Patients who rely on prescription medications may benefit from more transparent pricing and potentially lower costs.
  • Pharmacy Benefit Managers: PBMs will need to adjust their practices to comply with the new regulations, which may affect their operational models.

Procedural Aspects

  • The bill was introduced and referred to the Health Committee on September 5, 2025. Further legislative actions will determine its progression through the legislative process.
  • Related Bills:
    • A 10107: A prior-session bill that may have addressed similar issues.
    • S 5719: A companion bill in the Senate, indicating a parallel effort to address PBM practices.

Conclusion

Bill A 9045 represents a significant step towards reforming the practices of pharmacy benefit managers, with the potential to enhance transparency and fairness in the pharmaceutical industry. As the bill progresses through the legislative process, its provisions could lead to meaningful changes for pharmacies and consumers alike.

Compiled from official sources — confirm details with the bill’s official record.

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