Bill Text - HB383 (2024)

Relative to provider contract standards for pharmacy benefit managers.


Revision: Jan. 9, 2023, 3:29 p.m.

HB 383  - AS INTRODUCED

 

 

2023 SESSION

23-0683

09/05

 

HOUSE BILL 383

 

AN ACT relative to provider contract standards for pharmacy benefit managers.

 

SPONSORS: Rep. Rochefort, Graf. 1; Rep. Merchant, Sull. 6; Sen. Rosenwald, Dist 13

 

COMMITTEE: Commerce and Consumer Affairs

 

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ANALYSIS

 

This bill provides new provider contract standards for 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

23-0683

09/05

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty Three

 

AN ACT relative to provider contract standards for pharmacy benefit managers.

 

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

 

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 [the challenging pharmacy] all affected pharmacies or [pharmacist] 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.