Download User Guide

261 results returned.
Page   of  17

215 Ill. Comp. Stat. §§ 124/1 through 124/25: Network Adequacy and Transparency Act – Illinois
Status: Enacted     Year Enacted: 2017
Statutes prohibit an insurer from prohibiting a preferred provider from discussing any specific or all treatment options with beneficiaries or from advocating on behalf of beneficiaries within utilization review. If the insurer does not have …
Download
27 R.I. Gen. Laws § 27-41-14.1. Prohibition against restraint on provider-patient communications: Health Maintenance Organization Act – Rhode Island
Status: Enacted     Year Enacted: 1997
No health maintenance organization shall refuse to contract with or compensate for covered services an otherwise eligible health care provider solely because the provider has in good faith communicated with one or more of his …
Download
40 Pa. Cons. Stat. § 991.2113. Medical gag clause prohibition: Managed Care Plan Requirements – Pennsylvania
Status: Enacted     Year Enacted: 1998
Statute that prohibits medical gag clauses.
Download
40 Pa. Stat. and Pa. Cons. Stat. Ann. §§ 991.2101 through 991.2194: Quality Health Care Accountability and Protection – Pennsylvania
Status: Enacted     Year Enacted: 1998
Provisions governing managed care plans to ensure quality health care including prohibitions on financial incentives and gag clauses, standards regarding utilization review, prompt paymen of claims, and general responsibilities of managed care plans. Requires the …
Download
A 2205 (substituted by S 1330) – New York
Introduced: 2023    Status: Inactive / Dead    
Provides that no insurance contract or agreement between a health insurance plan and a health care provider, other than a residential health care facility, shall include a provision that: contains a most-favored-nation provision; or restricts …

A 2214 (see companion bill S 2690; combined with A 3993) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
PROHIBITS PHARAMCY BENEFIT MANAGERS FROM COLLECTING COPAYMENTS IN EXCESS OF CERTAIN AMOUNTS “CLAWBACKS”; REQUIRES CERTAIN LANGUAGE PROHIBITNG “GAG CLAUSES” IN CONTRACTS WITH PHARMACISTS: Prohibits a pharmacy benefits manager, in connection with any contract or arrangement …

A 3659 (see companion bill S 1007) – New York
Introduced: 2021    Status: In Process    
Prohibits an insurer or health maintenance organization from including certain requirements in insurance contracts. The legislation would ban anti-competitive hospital contracting practices that create higher health care prices for consumers and employers. Section one amends …

A 3993 (see companion bill S 2690; combined with A 2214) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
PROHIBITS PHARMACY BENEFIT MANAGERS FROM COLLECTING “CLAWBACK” COPAYMENTS; PROHIBITS “GAG CLAUSES” IN CONTRACTS WITH PHARMACISTS; PROVIDES CERTAIN PENALTES. A pharmacy benefits manager, in connection with any contract or arrangement with a private health insurer, prescription …

A 4041 (see ompanion bill S 2438) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
Would prohibit “gag clauses” by requiring a pharmacy benefits manager to include in any contract between the pharmacy benefits manager and a pharmacy in the State, language that permits the pharmacy to disclose to a …

A 536 (see companion bill S 1616/A 2841) – New Jersey
Introduced: 2022    Status: In Process    
Under the bill, a pharmacy or pharmacist may provide to an insured information regarding the insured’s total cost for pharmacist services for a prescription drug. A pharmacy benefits manager is not to prohibit a pharmacy …

A 8046 (see companion bill S 6629) – New York
Introduced: 2018    Status: Inactive / Dead    
Requires pharmacies to provide customers directly with the retail (before insurance) price of a prescription, in writing and electronically prior to purchase.

A 8169 (see companion bill S 7199) – New York
Introduced: 2021    Status: In Process    
Prohibits certain provisions in insurance and HMO contracts that requires the insurer to include within the scope of the contract all covered groups of the insurer for access to the insurer’s network of participating providers …

A 8781 (see companion bill S 6940) – New York
Introduced: 2017    Status: Inactive / Dead    
PHARMACY BENEFIT MANAGERS: Prohibits pharmacy benefit managers from prohibiting pharmacies from disclosing to consumers the cost of prescription medication, the availability of alternative medications or alternative means of purchasing prescription medications; and prohibits pharmacy benefit …

A 9893 (see companion bill S 7191A) – New York
Introduced: 2018    Status: Inactive / Dead    
RELATES TO ENHANCING PHARMACEUTICAL TRANSPARENCY AND CONSUMER PROTECTION: No contract for pharmacy services entered into in the state between a health insurance carrier or a pharmacy benefit manager and a pharmacy, pharmacist or a pharmacy’s …

AB 1091 – California
Introduced: 2023    Status: In Process    
Health Care Consolidation and Contracting Fairness Act of 2023. This bill, the Health Care Consolidation and Contracting Fairness Act of 2023, would prohibit a contract issued, amended, or renewed on or after January 1, 2024, …

AB 141 – Nevada
Introduced: 2019    Status: Enacted    
AN ACT relating to pharmacy benefit managers; prohibiting a pharmacy benefit manager from imposing certain limitations on the conduct of a pharmacist or pharmacy; and providing other matters properly relating thereto.

261 results returned.
Page   of  17

© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.