SB555 (2024) Detail

Relative to receipt of pharmaceutical rebates by insurers and pharmacy benefits managers.


CHAPTER 305

SB 555-FN - FINAL VERSION

 

03/07/2024   0832s

23May2024... 1794h

06/13/2024   2239CofC

2024 SESSION

24-2870

05/08

 

SENATE BILL 555-FN

 

AN ACT relative to receipt of pharmaceutical rebates by insurers and pharmacy benefits managers.

 

SPONSORS: Sen. Avard, Dist 12; Sen. Watters, Dist 4; Sen. Innis, Dist 7; Sen. Birdsell, Dist 19; Sen. Soucy, Dist 18; Sen. Bradley, Dist 3; Sen. Gannon, Dist 23; Sen. Pearl, Dist 17; Sen. Gendreau, Dist 1; Sen. Carson, Dist 14; Sen. Fenton, Dist 10; Rep. Pauer, Hills. 36; Rep. Mooney, Hills. 12

 

COMMITTEE: Health and Human Services

 

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AMENDED ANALYSIS

 

This bill revises the reporting requirements for pharmacy benefits managers and insurers regarding pharmaceutical rebates.  The bill also removes the prospective repeal of RSA 415-A:7, relative to insurer cost sharing of rebates.

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/07/2024   0832s

23May2024... 1794h

06/13/2024   2239CofC 24-2870

05/08

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty Four

 

AN ACT relative to receipt of pharmaceutical rebates by insurers and pharmacy benefits managers.

 

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

 

305:1  Pharmacy Benefits Manager Reporting.  Amend RSA 402-N:6, I to read as follows:

I.  Each pharmacy benefits manager shall submit an annual or quarterly report to the commissioner containing a list of health benefit plans it administered[,] and the [aggregate amount of all] rebates it collected from pharmaceutical manufacturers that were attributable to patient utilization in the state of New Hampshire during the prior calendar year.  This paragraph shall not apply to Medicaid, the Medicaid Care Management Program, the Ryan White HIV/AIDS Program administered by the department of health and human services, or self-funded plans such as the state employee health benefit plan.  The report submitted to the commissioner shall include the following information:

(a)  The aggregate number of rebates and total value received by the pharmacy benefit manager;

(b)  The aggregate number of rebates and total value distributed to the appropriate health care insurer;

(c)  The aggregate number of rebates and total value passed on to an insured of each health care insurer at the point of sale that reduced the insured’s applicable deductible, copayment, coinsurance, or other cost-sharing amount;

(d)  The individual and aggregate amount paid by the health care insurer to the pharmacy benefit manager for pharmacist services itemized by pharmacy, by product (at the unique NDC level), and by goods and services; and

(e)  The individual and aggregate amount a pharmacy benefit manager paid for pharmacist services itemized by pharmacy, by product, and by goods and services.

305:2  Pharmaceutical Rebates.  Amend RSA 415-A:7, III to read as follows:

III.  Beginning [November 1, 2020] March 1, 2025, and annually thereafter, an insurer shall file with the commissioner a report in the manner and form determined by the commissioner demonstrating the manner in which the insurer and/or its contracted entity for pharmacy benefit services has complied with this section. The report shall include at least the following:

(a)  An actuarial certification attesting:

(1)  All discounts and rebates received by health insurers were used to reduce costs for policyholders in compliance with paragraph II .

(2)  How rebates were remitted in the individual, small, and large group market.

(3)  If applied pursuant to subparagraph II(b), an explanation of how remittance was applied to both plan design, based on estimated rebates, and in future plan years to offset premium.

(4)  A description of the methodology employed to calculate the estimated rebate amount, for the purpose of applying to plan design.

(b)  Methodology for determining estimated rebate amount:

(1)  Insurers shall employ actuarial and analytical methodologies to estimate the total rebate amount expected to be received from drug manufacturers over a defined period.

(2)  The determination of the estimated rebate amount shall account for factors such as historical rebate data, anticipated changes in drug utilization, formulary modifications, and other pertinent variables.

(3)  The calculated estimated rebate amount shall adhere to generally accepted actuarial principles and industry best practices to ensure precision and dependability.

(4)  The calculation shall be documented and made available for review by the insurance commissioner, upon request.

III-a.  This section shall not apply to Medicaid, the Medicaid Care Management Program, the Ryan White HIV/AIDS Program administered by the department of health and human services, or self-funded plans such as the state employee health benefit plan.

305:3  Repeal.  2020, 15:2, relative to the prospective repeal of RSA 415-A:7, is repealed.

305:4  Effective Date.  This act shall take effect June 30, 2024.

 

Approved: July 26, 2024

Effective Date: June 30, 2024

 

 

Amendments

Date Amendment
Feb. 21, 2024 2024-0832s
March 21, 2024 2024-0967s
May 16, 2024 2024-1794h
June 5, 2024 2024-2239CofC

Links


Date Body Type
Feb. 14, 2024 Senate Hearing
Feb. 14, 2024 Senate Hearing
March 7, 2024 Senate Floor Vote
March 21, 2024 Senate Floor Vote
April 30, 2024 House Hearing
May 15, 2024 House Exec Session
May 15, 2024 House Floor Vote
June 6, 2024 House Floor Vote
June 13, 2024 House Floor Vote
June 13, 2024 Senate Floor Vote

Bill Text Revisions

SB555 Revision: 45751 Date: July 30, 2024, 7:49 a.m.
SB555 Revision: 42646 Date: June 13, 2024, 4:18 p.m.
SB555 Revision: 45032 Date: June 5, 2024, 8:14 a.m.
SB555 Revision: 42307 Date: May 29, 2024, 11:09 a.m.
SB555 Revision: 42079 Date: May 16, 2024, 8:30 a.m.
SB555 Revision: 41135 Date: April 24, 2024, 8:25 a.m.
SB555 Revision: 41338 Date: March 21, 2024, 9:48 a.m.
SB555 Revision: 40969 Date: Feb. 21, 2024, 4:28 p.m.
SB555 Revision: 40356 Date: Feb. 6, 2024, 2:24 p.m.
SB555 Revision: 45033 Date: Nov. 14, 2023, 8:11 a.m.

Docket


July 30, 2024: Signed by the Governor on 07/26/2024; Chapter 0305; Effective 06/30/2024


July 15, 2024: Enrolled (in recess of) 06/13/2024


July 11, 2024: Enrolled Adopted, VV, (In recess 06/13/2024); SJ 18


July 11, 2024: Enrolled Adopted, VV, (In recess 06/13/2024); SJ 18


July 15, 2024: Enrolled (in recess of) 06/13/2024


June 12, 2024: Conference Committee Report # 2024-2239c, Adopted, VV; 06/13/2024; SJ 17


June 13, 2024: Conference Committee Report 2024-2239c: Adopted, VV 06/13/2024 HJ 16 P. 15


June 6, 2024: Conference Committee Report # 2024-2239c Filed 06/06/2024; House Amendment + New Amendment HJ 15


June 4, 2024: ==RECONVENE== Committee of Conference Meeting: 06/04/2024, 12:30 pm, Room 100, SH


June 4, 2024: ==RECESSED== Committee of Conference Meeting: 06/04/2024, 09:30 am, Room 100, SH


June 3, 2024: ==RECESSED== Committee of Conference Meeting: 06/03/2024, 02:30 pm, Room 100, SH


May 30, 2024: Speaker Appoints: Reps. Hunt, Burroughs, Spier, Ammon 05/30/2024 HJ 15 P. 29


May 30, 2024: House Accedes to Senate Request for CofC (Rep. Hunt): MA VV 05/30/2024 HJ 15 P. 29


May 30, 2024: President Appoints: Senators Birdsell, Avard, Prentiss; 05/30/2024; SJ 16


May 30, 2024: Sen. Birdsell Moved Nonconcur with the House Amendment; Requests C of C, MA, VV; 05/30/2024; SJ 16


May 23, 2024: Ought to Pass with Amendment 2024-1794h: MA VV 05/23/2024 HJ 14 P. 7


May 23, 2024: Amendment # 2024-1794h: AA VV 05/23/2024 HJ 14 P. 7


May 16, 2024: Committee Report: Ought to Pass with Amendment # 2024-1794h 05/15/2024 (Vote 18-0; CC) HC 20 P. 7


May 8, 2024: Executive Session: 05/15/2024 10:00 am LOB 302-304


May 1, 2024: Work Session: 05/07/2024 01:15 pm LOB 302-304


April 9, 2024: Public Hearing: 04/30/2024 10:00 am LOB 302-304


April 2, 2024: Introduced (in recess of) 03/28/2024 and referred to Commerce and Consumer Affairs HJ 10 P. 228


March 21, 2024: Ought to Pass: RC 19Y-4N, MA; OT3rdg; 03/21/2024; SJ 7


March 21, 2024: Sen. Rosenwald Floor Amendment # 2024-0967s, AF, VV; 03/21/2024; SJ 7


March 13, 2024: Committee Report: Ought to Pass, 03/21/2024, Vote 5-2; SC 11


March 7, 2024: Ought to Pass with Amendment 2024-0832s, MA, VV; Refer to Finance Rule 4-5; 03/07/2024; SJ 6


March 7, 2024: Committee Amendment # 2024-0832s, AA, VV; 03/07/2024; SJ 6


Feb. 22, 2024: Committee Report: Ought to Pass with Amendment # 2024-0832s, 03/07/2024; Vote 5-0; CC; SC 9


Feb. 8, 2024: Hearing: 02/14/2024, Room 101, LOB, 09:15 am; SC 7


Feb. 12, 2024: ==ROOM CHANGE== Hearing: 02/14/2024, Room 100, SH, 09:15 am; ; SC 7


Dec. 14, 2023: To Be Introduced 01/03/2024 and Referred to Health and Human Services; SJ 1