HF 423 – Iowa

Status: In Process
Year Introduced: 2024
Link: https://www.legis.iowa.gov/legislation/BillBook?ga=90&ba=HF423

This bill pertains to the contractual relationship between pharmacies and covered entities participating in the 340B drug program. The 340B drug program, established under the Veterans Health Care Act of 1992, allows eligible healthcare providers, referred to as “covered entities”, to purchase outpatient drugs at significantly reduced prices. Contract pharmacies are pharmacies that have formed an agreement with a covered entity to dispense these discounted drugs to the covered entity’s qualifying patients. The bill proposes that insurers, health plans, third-party administrators, and pharmacy benefit managers cannot discriminate against covered entities and contract pharmacies. This includes not reimbursing these entities or pharmacies at lower rates than other similar entities and not imposing more restrictive contractual terms. Restrictions, according to the bill, could include excessive fees, stringent network participation requirements, and frequent or rigorous audits. Furthermore, there are prohibitions to prevent these health service facilitators from interfering with a patient’s choice to obtain their prescriptions from a covered entity or a contract pharmacy and from preventing covered entities from maximizing the value of their 340B program discounts. The commissioner of insurance has the authority to enforce compliance with these provisions, and a violation will be considered an unfair or deceptive act in the business of insurance. The bill maintains that these provisions should not conflict with any applicable state or federal laws or the state’s Medicaid plan. Lastly, it clarifies that this bill does not apply to operations under a contract with the state’s Medicaid agency or a Medicaid managed care organization.

Return to Database Search

© 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.

Associated Litigation:

No items found