HF 204 (see companion bill SF 292) – Iowa
Introduced: 2019 Status: Inactive / Dead
A bill for an act relating to continuity of care and nonmedical switching by health carriers, health benefit plans, and utilization review organizations, and including applicability provisions.
HF 728 (see companion bill SF 278) – Minnesota
Introduced: 2019 Status: Inactive / Dead
*See enacted companion bill SF 278. Pharmacy benefit managers licensure and regulations created, and rulemaking authorized. This bill requires PBMs to be licensed by the Board of Pharmacy under a new chapter of law, chapter …
Idaho Code Ann. § 54-1768. Prescriber-authorized substitution: Idaho Pharmacy Act – Idaho
Status: Enacted Year Enacted: 2018
A licensed prescriber may authorize a pharmacist to substitute a drug with another drug in the same therapeutic class that would, in the opinion of the pharmacist, have a substantially equivalent therapeutic effect even though …
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Iowa Code §§ 510B.1 through 510B.10: Regulation of Pharmacy Benefits Managers – Iowa
Status: Enacted Year Enacted: 2007
The commissioner may require a pharmacy benefits manager to submit information to the commissioner related to the pharmacy benefits manager’s pricing methodology for maximum reimbursement amount.
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Kan. Stat. Ann. §§ 39-7,116 through 7,121g: Drug Utilization Review Program – Kansas
Status: Enacted Year Enacted: 1990
The secretary of health and environment shall implement a drug utilization review program with the assistance of a medicaid drug utilization review board as provided in K.S.A. 39-7,119, and amendments thereto, to assure the appropriate …
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Ky. Rev. Stat. § 304.17A-535. Drug utilization waiver program; limitations on generic substitution; application to drug formulary: Managed Care Plans – Kentucky
Status: Enacted Year Enacted: 1998
A managed care plan shall include a drug utilization review program. A managed care plan that restricts pharmacy benefits to a drug formulary shall have an exceptions policy through which the managed care plan may …
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Md. Code, Ins. §§ 15-1604 through 15-1612: Pharmacy Benefits Managers, Part II Registration and Regulation of Pharmacy Benefits Managers – Maryland
Status: Enacted Year Enacted: 2008
A pharmacy benefits manager shall register with the Commissioner as a pharmacy benefits manager before providing pharmacy benefits management services in the State to purchasers. Form of application and fee
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Md. Code, Ins. §§ 15-1633 through 15-1639: Pharmacy Benefit Managers, Part VI Therapeutic Interchanges – Maryland
Status: Enacted Year Enacted: 2008
In any therapeutic interchange solicitation, the following shall be disclosed to the prescriber: that a therapeutic interchange is being solicited, the circumstances under which the originally prescribed drug will be covered by the purchaser, the …
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Mo. Rev. Stat. § 376.388. Definitions–pharmacy benefits manager requirements upon execution or renewal of contract with pharmacy–contract requirements–disputes regarding maximum allowable cost pricing appeals: Life, Health and Accident Insurance – Missouri
Status: Enacted Year Enacted: 2016
Definitions related to PBMs, etc. in Missouri.
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Mont. Code Ann. § 33-22-171. Maximum allowable cost list — limitations on drugs: Disability Insurance General Provisions – Montana
Status: Enacted Year Enacted: 2015
Specifications for a drug before a pharmacy benefit manager places or continues it on a maximum allowable cost list.
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Mont. Code Ann. § 33-22-172. Maximum allowable cost or reference price list — price formulation, updating, and disclosure — exceptions: Disability Insurance General Provisions – Montana
Status: Enacted Year Enacted: 2015
At the time it enters into a contract with a pharmacy and subsequently upon request, a plan sponsor, health insurance issuer, or pharmacy benefit manager shall provide the pharmacy with the sources used to determine …
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Mont. Code Ann. § 33-22-173. Maximum allowable cost or reference price list — appeals process: Disability Insurance General Provisions – Montana
Status: Enacted Year Enacted: 2015
If the final determination is a denial of the pharmacy’s appeal, the pharmacy benefit manager shall state the reason for the denial and provide the national drug code of an equivalent drug that is available …
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N.M. Stat. § 59A-23-12.1. Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions: Group and Blanket Health Insurance Contracts – New Mexico
Status: Enacted Year Enacted: 2018
Each group or blanket health insurance policy, health care plan and certificate of health insurance delivered or issued for delivery in this state that provides a prescription drug benefit for which any step therapy protocols …
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S 1215 – Massachusetts
Introduced: 2017 Status: Inactive / Dead
AN ACT TO REDUCE HEALTHCARE COSTS BY PROMOTING NON-BIASED PRESCRIBE EDUCATION. Would require the state’s health department to develop and implement an outreach and education program about the therapeutic and cost-effective utilization of prescription drugs …
S 1295 – Massachusetts
Introduced: 2019 Status: Inactive / Dead
For legislation to reduce healthcare costs by promoting non-biased prescriber education. Public Health.
S 1465 – Massachusetts
Introduced: 2021 Status: Inactive / Dead
For legislation to reduce healthcare costs by promoting non-biased prescriber education. Public Health.