Text to be removed highlighted in red.
1 Provider Contract Standards for Pharmacy Benefit Managers. Amend RSA 402-N:3, I(b)(3)(B) to read as follows:
(B) Identify the national drug code of a drug product that may be purchased by contracted pharmacies at a price at or below the maximum allowable cost; and
2 Rebilling; Pharmacy Benefit Managers. Amend RSA 402-N:3, I(b)(4)(B) to read as follows:
(B) Permit the challenging pharmacy or pharmacist to reverse and rebill the claim in question
3 New Subparagraph; Pharmacy Benefit Managers; Department of Insurance Cost Lists. Amend RSA 402-N:3, II by inserting after subparagraph (c) the following new subparagraph:
(d) Make available to the pharmacy and the insurance department all maximum allowable cost lists in use by the pharmacy benefits manager for all insurance plans administered within New Hampshire by the pharmacy benefits manager.
4 Effective Date. This act shall take effect 60 days after its passage.
Text to be added highlighted in green.
1 Provider Contract Standards for Pharmacy Benefit Managers. Amend RSA 402-N:3, I(b)(3)(B) to read as follows:
(B) Identify the national drug code , and the source of a drug product that may be purchased by contracted pharmacies at a price at or below the maximum allowable cost; and provide the name of a wholesaler servicing New Hampshire where the drug can be purchased; and
2 Rebilling; Pharmacy Benefit Managers. Amend RSA 402-N:3, I(b)(4)(B) to read as follows:
(B) Permit all affected pharmacies or pharmacists in this state to reverse and rebill the claim in question or any claim affected dating back to when the maximum allowable cost fell below actual cost. The pharmacy benefit manager shall notify all pharmacies in the network of the date that all claims can be reprocessed.
3 New Subparagraph; Pharmacy Benefit Managers; Department of Insurance Cost Lists. Amend RSA 402-N:3, II by inserting after subparagraph (c) the following new subparagraph:
(d) Make available to the pharmacy and the insurance department all maximum allowable cost lists in use by the pharmacy benefits manager for all insurance plans administered within New Hampshire by the pharmacy benefits manager.
4 Effective Date. This act shall take effect 60 days after its passage.