SB46 H JUD AM

Brandfass 3258

The Committee on the Judiciary moves to amend the bill on page one, by striking out everything after the enacting clause and inserting in lieu thereof the following:

“ARTICLE 51. PHARMACY AUDIT INTEGRITY and Transparency ACT.

§33-51-9. Regulation of Pharmacy Benefit Managers.

(a) A pharmacy and a pharmacist shall have the right to provide a covered individual with information related to lower cost alternatives and cost share for such covered individual to assist health care consumers in making informed decisions.  Neither a pharmacy nor a pharmacist shall be penalized by a pharmacy benefit manager for discussing information in this section or for selling a lower cost alternative to a covered individual, if one is available, without using a health insurance policy.

(b) A pharmacy benefit manager shall not collect from a pharmacy or a pharmacist a cost share charged to a covered individual that exceeds the total submitted charges by the pharmacy or pharmacist to the pharmacy benefit manager.

 (c) A pharmacy benefit manager may only directly or indirectly charge or hold a pharmacy or pharmacist responsible for a fee related to a claim if:

(1) The total amount of the fee is identified, reported, and specifically explained for each line item on the remittance advice of the adjudicated claim; or

(2) The total amount of the fee is apparent at the point of sale and not adjusted between the point of sale and the issuance of the remittance advice.

(d) This section shall not apply with respect to claims under an employee benefit plan under the Employee Retirement Income Security Act of 1974 or Medicare Part D.”