AB 315 – CaliforniaStatus: Enacted
Year Introduced: 2017
Year Enacted: 2018
This bill would require a pharmacy to inform a customer at the point of sale for a covered prescription drug whether the retail price is lower than the applicable cost-sharing amount for the prescription drug, unless the pharmacy automatically charges the customer the lower price. If the customer pays the retail price, the bill would require the pharmacy to submit the claim to the plan or insurer in the same manner as if the customer had purchased the prescription drug by paying the cost-sharing amount when submitted by the network pharmacy.
The bill would require pharmacy benefit managers to exercise good faith and fair dealing. Among other things, the bill would require a pharmacy benefit manager to notify a purchaser, as defined, in writing of any activity, policy, or practice of the pharmacy benefit manager that directly or indirectly presents a conflict of interest that interferes with the discharge of the pharmacy benefit manager’s duty to the purchaser to exercise good faith and fair dealing. The bill would require a pharmacy benefit manager to disclose, on a quarterly basis, and upon the request of the purchaser, certain information with respect to prescription product benefits specific to the purchaser, including, but not limited to, the aggregate wholesale acquisition costs from a pharmaceutical manufacturer or labeler for certain therapeutic drugs and any administrative fees received from a pharmaceutical manufacturer or labeler.
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