The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Cheryl Horne.
DIGEST
Mills (SB 410)
Proposed law provides for definitions of:
(1)Maximum Allowable Cost List
(2)National Drug Code (NDC)
(3)Pharmacist
(4)Pharmacist services
(5)Pharmacy
(6)Pharmacy benefits manager
(7)Pharmacy benefits plan or program
Proposed law allows a pharmacy benefits manager to use the NDC only when the following
conditions have been met:
(1)The NDC is listed as "A" or "B" rated in the most recent version of the FDA's Orange
Book.
(2)The NDC is available for purchase by pharmacies in the state from national or regional
wholesalers.
(3)The NDC is not obsolete.
Proposed law requires a pharmacy benefits manager to:
(1)Provide access to its Maximum Allowable Cost List.
(2)Update its Maximum Allowable Cost List on a timely basis.
(3) Provide a process for each pharmacy to receive prompt notification of an update.
Proposed law requires a pharmacy benefits manager to provide a reasonable administrative
appeal procedure within seven business days after the applicable fill date. Requires the pharmacy
benefits manager to respond to a challenge within seven business days after receipt of a challenge.
Proposed law requires a pharmacy benefits manager to perform the following if an appeal is
upheld:
(1)Make the change in the Maximum Allowable Cost List.
(2)Permit the challenging pharmacy or pharmacist to reverse and rebill the claim.
(3)Make the change effective for each similarly situated pharmacy.
Proposed law requires a pharmacy benefits manager to provide the challenging pharmacy or
pharmacist the NDC number if an appeal is denied.
Proposed law deems a violation of proposed law to be deceptive pursuant to present Unfair Trade
Practices and Consumer Protection Law.
Effective August 1, 2014.
(Adds R.S. 22:1863-1865)