Health and Human Services

Pharmacy benefit manager regulations passed

Senators passed a bill March 11 regulating pharmacy benefit managers in Nebraska.

Sen. Mark Kolterman
Sen. Mark Kolterman

LB767, introduced by Sen. Mark Kolterman of Seward, establishes licensure and regulation standards for pharmacy benefit managers — companies that manage prescription drug benefits on behalf of health insurers — by the state Department of Insurance.

Among other provisions, the bill:
• establishes an audit process for pharmacies;
• allows the DOI director to audit a PBM and assess penalties of up to $100,000 per violation;
• prohibits a PBM from charging any fee, chargeback or other adjustment to any pharmacy participating the federal 340B drug discount program;
• requires PBMs to update the maximum allowable cost price list at least every seven days;
• prohibits PBMs from excluding a pharmacy from participating in the PBM’s network if the pharmacy holds a specialty pharmacy accreditation; and
• prohibits a PBM from restricting certain actions by a pharmacist, including disclosing to a client the risks of treatment, informing a client of alternative treatments that may be available, describing the process used to authorize or deny a service or benefit and disclosing the financial incentives used by a health carrier.

LB767 passed on a vote of 48-0 and takes effect Jan. 1, 2023.

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