This bill aims to regulate noncompete covenants – agreements that restrict employees from working for a competing employer for a certain period after leaving their current jobs – by putting certain restrictions. For instance, if an employee makes less than 150 percent of the minimum wage, a noncompete covenant is not enforceable. Also, such a covenant with a non-low-wage employee is unenforceable unless the employer can prove the covenant is necessary due to a significant risk of unfair competition and that the covenant has been tailored specifically to mitigate this risk. The bill also prescribes penalties for employers violating these terms, including having them pay for attorney fees, court costs, lost wages, and other damages if the violation is willful, to the impacted employees. These employers could also be fined $5,000 per violation payable to the labor commissioner. This bill only applies to noncompete covenants entered after its effective date.

This bill aims to regulate pharmacy benefits managers (PBMs), pharmacies, and prescription drug benefits. It requires that any payments a covered person makes for a prescription drug must be applicable to any deductibles in the person’s health benefit plan. It states that a covered person must be permitted to fill a prescription at any pharmacy within the state, given the terms and conditions of their health benefit plan are accepted by the selected pharmacy. It explicitly prohibits PBMs from imposing different cost-sharing or additional fees based on the selection of the pharmacy by a covered person. PBMs are also prohibited from requiring a person to purchase pharmacy services or drugs strictly from a mail-order pharmacy. The bill mandates that PBMs must provide each pharmacy in a network access to the maximum allowable cost list, available through a secure internet site, and a process for pharmacies to appeal a maximum allowable cost or a reimbursement made under the maximum allowable cost list. The bill only applies to PBMs that manage a health carrier’s prescription drug benefit in the state after the bill becomes effective.

This bill aims to regulate noncompete covenants (agreements restricting an employee from working for competitors or starting a similar business post-employment) involving nurses. Noncompete covenants for nurses making less than 150% of the minimum wage are deemed unenforceable and in violation of the bill. For nurses exceeding this wage threshold, a noncompete covenant can only be enforced if the employer proves it’s necessary to prevent unfair competition and that it was narrowly tailored. The bill includes exceptions and penalties for violations. The bill only applies to noncompete covenants entered into after the bill is in effect.

This bill is designed to regulate the operations of Pharmacy Benefits Managers (PBMs) in the state of Iowa. It introduces a system of reverse auctions to determine which PBM will provide services for public sector health plans. The auctions are automated, competitive bidding processes conducted online. The bill also offers a technology platform to conduct these auctions and calls for real-time analysis and comparisons of price bids from different PBMs. A detailed report after each round of bidding is to be produced as well. The system is also designed to review 100% of invoiced PBM’s prescription drug claims in real-time and check for deviations from agreed contract terms. The bill clarifies that the cost of the platform and its operation should not burden the state; instead, the winning PBM is responsible for the expense. Other provisions in the legislation include the possibility for self-funded private sector health plans to utilize the technology platform for their reverse auction and the requirement for PBMs to provide access to pharmacy claim data for administration and management purposes.

This bill relates to an insurer’s duty of good faith in negotiations. Under the bill, it shall be an unfair method of competition and unfair or deceptive act or practice in the business of insurance for an insurer to fail to negotiate in good faith all charges with a hospital licensed pursuant to Code chapter 135B. “Good faith” is defined by the bill as honesty in fact and the observance of reasonable commercial standards of fair dealing in the trade. “Insurer” is also defined in the bill.

This bill addresses pharmacy benefit managers (PBMs), pharmacies, and prescription drug pricing. A pharmacy benefits manager acts as a middleman between insurers, pharmacies, and drug manufacturers, assisting in negotiating drug prices and establishing a list of covered drugs. The bill prohibits a PBM from treating any pharmacy or pharmacist unfairly. Starting from July 1, 2024, it requires all related contracts executed, adjusted, or renewed to use a pass-through pricing model, which is a method where payments from third-party payors to PBMs for prescription drugs are equal to the payments the PBMs make to pharmacies. It also excludes the allowance of spread pricing, which is a practice where a PBM charges a third-party payor more for prescription drugs than the amount the PBM pays to the pharmacy for the same drugs, unless the entire amount caused by spread pricing is passed through by the PBMs. Furthermore, the bill mandates PBMs to provide a mechanism for pharmacies to appeal a maximum allowable cost (MAC), which refers to the maximum amount that an insurer will pay a pharmacy for a specific prescription drug.

This bill pertains to pharmacy benefits managers (PBM), pharmacies, and prescription drug benefits. It mandates that any amount paid by a person for a drug must be applied to any deductible of that person’s health benefit plan. It also forbids the prohibition of a person from filling a drug order at any pharmacy located in the state. PBMs are forbidden from imposing different cost-sharing or additional fees on a person based on the pharmacy chosen for filling their prescription. PBMs also cannot require a person to purchase pharmacy services exclusively through a mail order pharmacy provider to receive payment or reimbursement. The concept of a “mail order pharmacy provider” is defined in this bill. The provisions are applicable to PBMs managing a health carrier’s prescription drug benefit in the state from the effective date of this bill.

This bill pertains to the contractual relationship between pharmacies and covered entities participating in the 340B drug program. The 340B drug program, established under the Veterans Health Care Act of 1992, allows eligible healthcare providers, referred to as “covered entities”, to purchase outpatient drugs at significantly reduced prices. Contract pharmacies are pharmacies that have formed an agreement with a covered entity to dispense these discounted drugs to the covered entity’s qualifying patients. The bill proposes that insurers, health plans, third-party administrators, and pharmacy benefit managers cannot discriminate against covered entities and contract pharmacies. This includes not reimbursing these entities or pharmacies at lower rates than other similar entities and not imposing more restrictive contractual terms. Restrictions, according to the bill, could include excessive fees, stringent network participation requirements, and frequent or rigorous audits. Furthermore, there are prohibitions to prevent these health service facilitators from interfering with a patient’s choice to obtain their prescriptions from a covered entity or a contract pharmacy and from preventing covered entities from maximizing the value of their 340B program discounts. The commissioner of insurance has the authority to enforce compliance with these provisions, and a violation will be considered an unfair or deceptive act in the business of insurance. The bill maintains that these provisions should not conflict with any applicable state or federal laws or the state’s Medicaid plan. Lastly, it clarifies that this bill does not apply to operations under a contract with the state’s Medicaid agency or a Medicaid managed care organization.

This bill relates to manufacturers and wholesalers of 340B drugs. “340B drug”, “manufacturer”, and “wholesaler” are defined in the bill. The bill prohibits a manufacturer or wholesaler from, directly or indirectly, denying, restricting, or interfering with either the acquisition or purchase of a 340B drug by a covered entity, or the delivery of a 340B drug to a H.F. _____ contract pharmacy, unless otherwise prohibited by the United States department of health and human services. The bill prohibits a manufacturer or wholesaler from requiring reporting requirements or imposing contractual restrictions that are not required by law in order for a covered entity or contract pharmacy to purchase and receive 340B drugs.

This bill directs the department of health and human services to establish a study committee to investigate the potential for a state-based health insurance marketplace in Iowa. This committee is set to examine the practices of other states that have adopted a state-based insurance marketplace, whether they operate independently or in conjunction with the federal marketplace. By January 1, 2025, the department is to submit a report to the general assembly detailing findings and recommendations, which should include an assessment of cost impacts, quality of health plan coverage, state-based premium tax credits, and potential challenges and opportunities for Iowa. The report will also examine the cost and potential savings of establishing a state-based health insurance marketplace outside of the federal platform.