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Legislative Year: 2025 Change
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Bill Detail: HB25-1094

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Title Pharmacy Benefit Manager Practices
Status Introduced In House - Assigned to Health & Human Services (01/27/2025)
Bill Subjects
  • Health Care & Health Insurance
House Sponsors K. Brown (D)
D. Johnson (R)
Senate Sponsors D. Roberts (D)
B. Pelton (R)
House Committee Health and Human Services
Senate Committee
Date Introduced 01/27/2025
AI Summary
Summary

The bill:
  • Allows a pharmacy benefit manager (PBM) to earn income
derived from the assessment of a flat-dollar service fee;
  • Prohibits a PBM from earning income based on the cost of
a prescription drug;
  • Prohibits a PBM from designing a formulary to favor a
certain branded pharmaceutical or biologic;
  • Sets the amount that a PBM shall reimburse an unaffiliated
pharmacy or a PBM-affiliated retail, mail order, or
specialty pharmacy for a prescription drug;
  • Requires a PBM to credit income derived from a source
other than a flat-dollar service fee to a health insurance
carrier (carrier) or a self-funded health benefit plan; and
  • Requires a PBM to make certain documents and data
available to a carrier, a self-funded plan, or the
commissioner of insurance upon request.

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with Amendments
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