S 92 – Vermont

Status: Enacted
Year Introduced: 2018
Year Enacted: 2018
Link: https://legislature.vermont.gov/bill/status/2018/S.92

Requires pharmacists to dispense the lowest priced generic or interchangeable product. Would require an insurer to annually file a summary of proposed rates, including an analysis of the impact of drug cost on premium increases. Separately, would require insurers of different sizes to report on a specified number of most frequently prescribed drugs by average wholesale price for each drug, by the total spend, and by higher year on year price increases. Would require a subset of manufacturers to provide cost justification to the Attorney General, who will provide the report from the information received from manufacturers. Green Mountain Care Board shall post the report on its website, Requires manufacturers notice to the Attorney General of new drug launches priced at more than $670 and supply information about marketing and sales volume and other information to the Attorney General. Would require pharmacy benefit manager transparency as well. Prevents pharmacy benefit manager or other entity paying pharmacy claims from (1) imposing a higher co-payment for a prescription drug than the co-payment applicable to the type of drug purchased under the insured’s health plan; (2) imposing a higher co-payment for a prescription drug than the maximum allowable cost for the drug; (3) requiring a pharmacy to pass through any portion of the insured’s co-payment to the pharmacy benefit manager or other payer; or (4) prohibiting or penalizing a pharmacy or pharmacist for providing information to an insured regarding the insured’s cost-sharing amount for a prescription drug.

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