RÉSUMÉ DIGEST
ACT 358 (HB 548) 2023 Regular Session Turner
New law creates the "Defending Affordable Prescription Drug Costs" Act.
New law provides for definitions of certain terms including "340B drug" and "340B entity".
New law prohibits a health insurance issuer, pharmacy benefit manager, or other third-party
payor or its agent from taking any of the following actions:
(1)Reimbursing a 340B entity for 340B drugs at a lower rate than a non-340B entity.
(2)Imposing additional or different terms, conditions, or fees on a 340B entity compared
to a non-340B entity on the basis that the entity is a 340B entity or that the drug is a
340B drug.
(3)Requiring a 340B entity to reverse, resubmit, or clarify a claim after initial
adjudication unless these actions are in the normal course of pharmacy business.
(4)Preventing or interfering with any patient's choice to receive 340B drugs from a 340B
entity by placing any additional requirements, restrictions, or unnecessary burdens
on 340B entities that result in administrative costs or fees unless the action is
required by Medicare and Medicaid Services or the La. Dept. of Health.
(5)Including any provision in a contract between a health insurance issuer, pharmacy
benefit manager, or other third-party entity and a 340B entity that discriminates
against a 340B entity or prevents or interferes with a patient's choice to receive a
prescription drug from a 340B entity.
(6)Requiring or compelling the submission of ingredient costs or pricing data pertaining
to 340B drugs.
(7)Excluding any 340B entity from a health insurance issuer, pharmacy benefit manager,
or other third-party payor network on the basis that the 340B entity dispenses 340B
drugs.
New law provides that the prohibitions on a health insurance issuer, pharmacy benefit
manager, or other third-party payor shall not apply to the La. Medicaid program as a payor
when Medicaid provides reimbursement for covered outpatient drugs in accordance with
existing law.
New law prohibits actions by a manufacturer or distributor that would deny, restrict, prohibit,
or otherwise interfere with the acquisition of a 340B drug by a pharmacy that is under
contract with a healthcare facility that participates in the 340B drug discount program.
New law provides that the commission of any act prohibited by new law constitutes a
violation Unfair Trade Practices and Consumer Protection Law except there shall be no right
to bring private action.
New law provides that nothing in new law will be less restrictive than or construed to
conflict with federal law.
Effective August 1, 2023.
(Adds R.S. 40:2881-2886)