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305 Ill. Comp. Stat. § 5/5-30.1. Managed care protections: Medical Assistance – Illinois
Status: Enacted     Year Enacted: 2014
An MCO shall pay any provider of emergency services that does not have in effect a contract with the contracted Medicaid MCO. The default rate of reimbursement shall be the rate paid under Illinois Medicaid …
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A 1249 – New Jersey
Introduced: 2022    Status: In Process    
The Governor’s Fiscal Year 2022 budget recommendations include the enactment of legislation to require the State Health Benefits Commission and School Employees’ Health Benefit Commission to implement a referenced based pricing program for certain elective …

A 4305 (see companion bill S 220) – New Jersey
Introduced: 2018    Status: Inactive / Dead    
SETS LEVEL FOR HEALTH CARE BENEFITS; REQUIRES EMPLOYEE CONTRIBUTIONS; PROHIBITS REIMBURSEMENT OF MEDICARE PART B; ADDS MEMBER TO SHBP/SEHBP PLAN DESIGN COMMITTEES; REQUIRES RETIREES TO PURCHASE HEALTH BENEFITS THROUGH EXCHANGES; PROVIDES SUBSIDES FOR OUT-OF-POCKET COSTS. …

A 851 – New Jersey
Introduced: 2018    Status: Inactive / Dead    
SETS LEVEL FOR HEALTH CARE BENEFITS; REQUIRES EMPLOYEE CONTRIBUTIONS; PROHIBITS REIMBURSEMENT OF MEDICARE PART B; ADDS MEMBER TO SHBP/SEHBP PLAN DESIGN COMMITTEES; REQUIRES RETIREES TO PURCHASE HEALTH CARE THROUGH EXCHANGES. Under the bill, all government …

Ga. Code Ann. § 33-64-11. Prohibited activities of pharmacy benefits manager: Regulation and Licensure of Pharmacy Benefits Managers – Georgia
Status: Enacted     Year Enacted: 2017
A pharmacy benefits manager shall be proscribed from prohibiting a pharmacist or pharmacy from providing an insured individual information on the amount of the insured’s cost share for such insured’s prescription drug and the clinical …
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H 1154 – Massachusetts
Introduced: 2019    Status: Inactive / Dead    
Relative to pharmacy benefit managers and pharmaceutical manufacturing companies. Health Care Financing.

H 1265 – Massachusetts
Introduced: 2021    Status: Inactive / Dead    
Relative to the transparency and affordability of the Group Insurance Commission. Health Care Financing. There shall be a special commission governed by section 2A of chapter 4 of the General Laws to: (i) assess public …

H 735 – Vermont
Introduced: 2022    Status: Inactive / Dead    
An act relating to considering using reference-based pricing for the State employees’ health plan. This bill proposes to direct the Department of Human Resources to convene a working group comprising representatives of the Department, labor …

HB 1003 – Indiana
Introduced: 2023    Status: Inactive / Dead    
Health matters. Allows a credit against the state tax liability of an employer with fewer than 50 employees if the employer has adopted a health reimbursement arrangement in lieu of a traditional employer provided health …

HB 1004 – Indiana
Introduced: 2023    Status: Enacted    
Establishes the health care cost oversight task force and sets forth duties of the task force. Provides a credit against state tax liability to certain physicians who have an ownership interest in a physician practice …

HB 1501 – Florida
Introduced: 2022    Status: Inactive / Dead    
Defines “reference-based pricing”; authorizes cost savings to be paid in cash to enrollee; requires certain contracted entities to use reference-based pricing program to set reimbursement rates.

HB 5431 (see companion bill SB 98) – Rhode Island
Introduced: 2023    Status: In Process    
Prohibits the state, ERISA or any health plans to purchase referenced drugs for a cost higher than the referenced rate.

HB 5727 – Connecticut
Introduced: 2023    Status: Inactive / Dead    
An Act concerning prescription drug costs. To provide that no prescription drug manufacturer may sell a prescription drug in this state at a price that exceeds such drug’s reference price.

HB 5842 (see companion bill SB 167) – Rhode Island
Introduced: 2021    Status: Inactive / Dead    
AN ACT RELATING TO FOOD AND DRUGS — PRESCRIPTION DRUG COST PROTECTION: Prohibits the state, ERISA or any health plans to purchase referenced drugs for a cost higher than the referenced rate.

HB 7803 – Rhode Island
Introduced: 2022    Status: Enacted    
AN ACT RELATING TO HUMAN SERVICES — PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (Ensures that all hospitals and hospital-owned professional practices accept payment for all-inclusive elderly care which is no more than one hundred …

HB 7877 (see companion bill SB 2076) – Rhode Island
Introduced: 2022    Status: Inactive / Dead    
Prohibits the state, ERISA or any health plans to purchase referenced drugs for a cost higher than the referenced rate.

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