An Act Establishing A Duty Of Care Owed By Pharmacy Benefits Managers To Health Carriers Or Other Health Benefit Plan Sponsors.
The enactment of SB00090 would have significant implications for the insurance sector, particularly in the relationship between PBMs and health benefit plan sponsors. By imposing a fiduciary responsibility, the bill seeks to promote transparency and accountability among PBMs, thereby potentially improving the quality of service that health carriers receive. This shift could lead to enhanced trust within the healthcare system as stakeholders find reassurance in the legal obligations imposed on PBMs to act in the best interests of their clients.
SB00090, titled 'An Act Establishing A Duty Of Care Owed By Pharmacy Benefits Managers To Health Carriers Or Other Health Benefit Plan Sponsors', aims to define and establish a fiduciary duty for pharmacy benefits managers (PBMs) towards health carriers and other sponsors of health benefit plans. The objective of this legislation is to ensure that PBMs operate with a legal obligation to prioritize the interests of these health carriers and plan sponsors in their operations and decision-making processes. This aligns PBMs' responsibilities more closely with those of traditional fiduciaries in the insurance realm.
While the legislation is seen by some as a necessary reform, there may be points of contention regarding the practical implementation and ramifications of defining the duties of PBMs. Concerns may arise about how such a fiduciary duty will be enforced and whether it could lead to increased costs for health benefit plans if PBMs are held to higher standards of accountability. Additionally, stakeholders may debate the extent to which this bill could alter the competitive landscape among PBMs, and whether it might inadvertently drive up health care costs for consumers.
The introduction of SB00090 follows ongoing discussions regarding the role of PBMs in managing prescription drug benefits and their influence on drug pricing and access to medications. By formalizing the duties of PBMs, this bill attempts to address some of the criticisms aimed at these entities, particularly those related to transparency in drug cost negotiations and the management of rebates.