Bill Text - HB671 (2020)

Relative to pharmacy benefit manager business practices, licensure, and transparency.


Revision: Jan. 16, 2019, 10:24 a.m.

HB 671-FN - AS INTRODUCED

 

 

2019 SESSION

19-0800

01/10

 

HOUSE BILL 671-FN

 

AN ACT relative to pharmacy benefit manager business practices, licensure, and transparency.

 

SPONSORS: Rep. Butler, Carr. 7; Rep. Marsh, Carr. 8; Rep. Knirk, Carr. 3; Rep. Hennessey, Graf. 1; Sen. Sherman, Dist 24

 

COMMITTEE: Commerce and Consumer Affairs

 

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ANALYSIS

 

This bill establishes an RSA chapter governing pharmacy benefit managers.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

19-0800

01/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Nineteen

 

AN ACT relative to pharmacy benefit manager business practices, licensure, and transparency.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

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.

 

LBAO

19-0800

1/15/19

 

HB 671-FN- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to pharmacy benefit manager business practices, licensure, and transparency.

 

FISCAL IMPACT:      [ X ] State              [ X ] County               [ X ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2020

FY 2021

FY 2022

FY 2023

   Appropriation

$0

$0

$0

$0

   Revenue

Indeterminable

Indeterminable

Indeterminable

Indeterminable

   Expenditures

Indeterminable

Indeterminable

Indeterminable

Indeterminable

Funding Source:

  [    ] General            [ X ] Education            [    ] Highway           [ X ] Other - Various Governmental Funds

 

 

 

 

 

COUNTY:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable

Indeterminable

Indeterminable

Indeterminable

 

 

 

 

 

LOCAL:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable

Indeterminable

Indeterminable

Indeterminable

 

METHODOLOGY:

This bill establishes RSA 420-P governing pharmacy benefit managers (PBMs).

 

The Insurance Department assumes the bill would not create any new categories of PBMs other than those identified in RSA420-J:3, XXVIII-a.  The Department assumes there could be increased costs to PBMs to the extent a PBM is not complying with the new provisions.  Any increase in operating costs may result in increase claims costs, premium costs and state premium tax revenue. The Department indicates it could handle any new administrative responsibilities arising from the bill within its existing resources.  

 

The Department of Administrative Services indicates the fiscal impact to the State is indeterminable.  The Department assumes the bill would have a minimal, if any, impact on the State Employees and Retiree Health Benefit Plans.  

The Department of Health and Human Services states since the bill makes no substantive changes to the standards or regulations governing Pharmacy Benefit Managers, it will have no fiscal impact on the Department

 

AGENCIES CONTACTED:

Insurance Department, and Departments of Administrative Services and Health and Human Services