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