HB671 (2020) Compare Changes

The Bill Text indicates a repeal. This means the text being replaced is not available in the bill, and the unchanged text displayed is incomplete. The original text can be viewed by following the link to the RSA. Also, an accompanying re-enactment is not handled currently, and displayed in both unchanged and changed versions.
The Bill Text indicates a new section is being inserted. This situation is not handled right now, and the new text is displayed in both the changed and unchanged versions.

Unchanged Version

Text to be removed highlighted in red.

1 New Chapter; Pharmacy Benefit Managers. Amend RSA by inserting after chapter 420-O the following new chapter:

CHAPTER 420-P

PHARMACY BENEFIT MANAGERS

420-P:1 Purpose and Intent. The purpose and intent of this chapter is to provide standards for certain fundamental operations of pharmacy benefit managers. The establishment of these standards shall ensure regulatory and quality consistency among licensees administering pharmacy benefit services and shall enable consumers to make informed decisions in their relationships with pharmacy benefit managers.

420-P:2 Definitions. In this chapter:

I. "Commissioner" means the commissioner of the insurance department.

II. "Pharmacy benefits manager" means a person who performs pharmacy benefits management services, including a person acting on behalf of a pharmacy benefits manager in a contractual or employment relationship in the performance of pharmacy benefits management services for a covered entity. "Pharmacy benefits manager" shall not include a health insurer licensed in this state if the health insurer or its subsidiary is providing pharmacy benefits management services exclusively to its own insureds, or a private single employer self-funded plan that provides such benefits or services directly to its beneficiaries. "Pharmacy benefits management" means the administration of prescription drug benefits provided by a covered entity under the terms and conditions of the contract between the pharmacy benefits manager and the covered entity and the provision of mail order pharmacy services.

420-P:3 Requirements for Pharmacy Benefit Managers. The following RSA sections shall be construed to apply to pharmacy benefit managers, except to the extent that the commissioner determines that the nature of pharmacy benefit managers renders such provisions inappropriate: RSA 402-H, 415-J, RSA 420-J:5, RSA 420-J:5-a, RSA 420-J:5-b, RSA 420-J:5-c, RSA 420-J:5-d, RSA 420-J:5-e, RSA 420-J:6, RSA 420-J:7, RSA 420-J:7-b, I(a), RSA 420-J:7-b, I(b), RSA 420-J:7-b, II, RSA 420-J:7-b, III, RSA 420-J:7-b, IV, RSA 420-J:7-b, IV-a, RSA 420-J:7-b, IV-b, RSA 420-J:7-b, IV-c, RSA 420-J:7-b, V, RSA 420-J:7-b, VII, RSA 420-J:7-b, X, RSA 420-J:7-e, RSA 420-J:8, RSA 420-J:8-a, RSA 420-J:8-b, RSA 420-J:8-c, RSA 420-J:9, RSA 420-J:10, RSA 420-J:11, RSA 420-J:12, RSA 420-J:13, RSA 420-J:14, RSA 420-J:15, RSA 420-J:17, RSA 420-E, RSA 420-G:11, RSA 420-G:11-a, RSA 420-G:14-a, RSA 420-G:15, and RSA 420-G:16.

2 Repeal. RSA 420-J:3, XXVIII-a, relative to a definition of pharmacy benefit manager, is repealed.

3 Effective Date. This act shall take effect 60 days after its passage.

Changed Version

Text to be added highlighted in green.

1 New Chapter; Pharmacy Benefit Managers. Amend RSA by inserting after chapter 420-O the following new chapter:

CHAPTER 420-P

PHARMACY BENEFIT MANAGERS

420-P:1 Purpose and Intent. The purpose and intent of this chapter is to provide standards for certain fundamental operations of pharmacy benefit managers. The establishment of these standards shall ensure regulatory and quality consistency among licensees administering pharmacy benefit services and shall enable consumers to make informed decisions in their relationships with pharmacy benefit managers.

420-P:2 Definitions. In this chapter:

I. "Commissioner" means the commissioner of the insurance department.

II. "Pharmacy benefits manager" means a person who performs pharmacy benefits management services, including a person acting on behalf of a pharmacy benefits manager in a contractual or employment relationship in the performance of pharmacy benefits management services for a covered entity. "Pharmacy benefits manager" shall not include a health insurer licensed in this state if the health insurer or its subsidiary is providing pharmacy benefits management services exclusively to its own insureds, or a private single employer self-funded plan that provides such benefits or services directly to its beneficiaries. "Pharmacy benefits management" means the administration of prescription drug benefits provided by a covered entity under the terms and conditions of the contract between the pharmacy benefits manager and the covered entity and the provision of mail order pharmacy services.

420-P:3 Requirements for Pharmacy Benefit Managers. The following RSA sections shall be construed to apply to pharmacy benefit managers, except to the extent that the commissioner determines that the nature of pharmacy benefit managers renders such provisions inappropriate: RSA 402-H, 415-J, RSA 420-J:5, RSA 420-J:5-a, RSA 420-J:5-b, RSA 420-J:5-c, RSA 420-J:5-d, RSA 420-J:5-e, RSA 420-J:6, RSA 420-J:7, RSA 420-J:7-b, I(a), RSA 420-J:7-b, I(b), RSA 420-J:7-b, II, RSA 420-J:7-b, III, RSA 420-J:7-b, IV, RSA 420-J:7-b, IV-a, RSA 420-J:7-b, IV-b, RSA 420-J:7-b, IV-c, RSA 420-J:7-b, V, RSA 420-J:7-b, VII, RSA 420-J:7-b, X, RSA 420-J:7-e, RSA 420-J:8, RSA 420-J:8-a, RSA 420-J:8-b, RSA 420-J:8-c, RSA 420-J:9, RSA 420-J:10, RSA 420-J:11, RSA 420-J:12, RSA 420-J:13, RSA 420-J:14, RSA 420-J:15, RSA 420-J:17, RSA 420-E, RSA 420-G:11, RSA 420-G:11-a, RSA 420-G:14-a, RSA 420-G:15, and RSA 420-G:16.

2 Repeal. RSA 420-J:3, XXVIII-a, relative to a definition of pharmacy benefit manager, is repealed.

3 Effective Date. This act shall take effect 60 days after its passage.