Legislation


HB 194 – Delaware

Status: Enacted
Year Introduced: 2019
Year Enacted: 2019
Link: http://legis.delaware.gov/BillDetail?LegislationId=47636

Requirements for maximum allowable cost pricing. To place a drug on a maximum allowable cost list, a pharmacy benefits manager must ensure that the drug meets all of the following requirements: It is listed as “A” or “B” rated in the most recent version of the FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations, also known as the Orange Book, or has an “NR” or “NA” rating or a similar rating by a nationally recognized reference. It is generally available for purchase by pharmacies in this State from national or regional wholesalers.If it is manufactured by more than 1 manufacturer, the drug is available for purchase by a contracted pharmacy, including a contracted retail pharmacy, in this State from a wholesale distributor with a permit in this State. A pharmacy benefits manager engaging in maximum allowable cost pricing (1) Make available to each network provider at the beginning of the term of the network provider’s contract, and upon renewal of the contract, the sources utilized to determine the maximum allowable cost pricing.(2) Provide a process for a network pharmacy provider to readily access the most recent maximum allowable cost specific to that provider in an electronic format as updated in accordance with the requirements of this section.


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