Status: Enacted
Year Enacted: 2016
Governs PBM cost transparency requirements.
Status: Enacted
Year Enacted: 2019
When calculating an enrollee’s contribution to any out-of-pocket maximum, deductible, copayment, coinsurance or other applicable cost sharing requirement, the health insurer that provides pharmacy benefits or a pharmacy benefits manager that administers pharmacy benefits for […]
Status: Enacted
Year Enacted: 2018
Provides regulation of pharmacy benefit managers, such as they may not prohibit a pharmacist or pharmacy from providing an insured individual information on the amount of the insured’s cost share for the insured’s prescription drug […]
Status: Enacted
Year Enacted: 2015
Provides that change in choice of provider without express consent is prohibited.
Status: Enacted
Year Enacted: 2009
Statutes under the Fair Disclosure of State Funded Payments for Pharmacists’ Services Act
Cal. Health & Safety Code §§ 127675 through 127686: Prescription Drug Pricing for Purchasers – California
Status: Enacted
Year Enacted: 2017
It is the intent of the Legislature in enacting this chapter to provide notice and disclosure of information relating to the cost and pricing of prescription drugs in order to provide accountability to the state […]
Status: Enacted
Year Enacted: 2010
A health insurer shall annually provide claims data at no charge to a large group purchaser if the large group purchaser requests the information and otherwise meets the requirements of this section.
Colo. Rev. Stat. § 10-16-122. Access to prescription drugs: Colorado Health Care Coverage Act – Colorado
Status: Enacted
Year Enacted: 1998
A pharmacy benefit manager shall allow participation by any provider in the network service area. Regulates other aspects of any service provided by a pharmacy benefit manager.
Status: Enacted
Year Enacted: 2013
Outlines the requirements for any pharmacy benefit manager that audits a pharmacy. It also outlines the types of materials that a pharmacy must keep and provide to any auditor.
Status: Enacted
Year Enacted: 2018
A consumer has the right to know about any options they have to reduce costs of drugs at a pharmacy. This act mandates that pharmacies provide information about the price of perscription drugs.
Status: Enacted
Year Enacted: 2013
Outlines the process by which a pharmacy or pharmacy benefit manager can institute prior authorization procedures.
Conn. Gen. Stat. §§ 38a-479aaa through 38a-479iii. Health Insurance—Health Insurance: Pharmacy Benefits Managers – Connecticut
Status: Enacted
Year Enacted: 2007
Statutes governing pharmacy benefit managers.
Del. Code Ann. tit. 18 §§ 3301A-3310A – Delaware
Status: Enacted
Requires pharmacy benefit managers who employ “maximum allowable cost,” or MAC pricing for multi-sourced drugs to follow set standards in composing and updating the provide information on MAC and how it is determined to pharmacies […]
Del. Code tit. 18, § 3321A through 3324A: Maximum Allowable Cost Pricing for Prescription Drugs – Delaware
Status: Enacted
Year Enacted: 2016
To place a drug on a maximum allowable cost list, a pharmacy benefit manager must ensure that the drug meets the following requirements.
Status: Enacted
Year Enacted: 2018
A contract between a pharmacy benefits manager and a pharmacy may not prohibit a pharmacy or pharmacist from doing any of the following.
Status: Enacted
Year Enacted: 2018
Requires PBMs to engage in activities related to price transparency, including updating maximum allowable pricing information, and allowing pharmacists to disclose whether cost sharing obligations exceed the drug’s retail price.
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