Missouri Senate Bill SB921

Missouri 2022 Regular Session

• Introduced: 1/5/22
• Refer: 2/16/22

Caption

Enacts provisions relating to payments for prescription drugs

Impact

If enacted, SB921 would significantly impact aspects of health care law pertaining to prescription drug pricing and the responsibilities of PBMs in Missouri. The bill would enforce stricter accountability measures for these organizations, particularly in how they manage and report rebate information. This could lead to improved pricing for patients and insurers, fostering a more competitive marketplace. Furthermore, by enabling pharmacies to appeal decisions regarding pricing more effectively, the legislation aims to ensure that drug costs remain fair and accessible to consumers, potentially reducing out-of-pocket expenses for many residents.

Summary

SB921, introduced by Senators White and Eslinger, aims to modify the existing framework governing pharmacy benefits managers (PBMs) and the pricing of prescription drugs. The bill seeks to repeal and replace several sections of Missouri law related to how PBMs administer health care plans and handle rebates from pharmaceutical manufacturers. One of the primary objectives of this legislation is to enhance transparency in the rebate processes and ensure that patients have better access to affordable prescription drugs. The bill outlines specific reporting requirements for pharmacy benefits managers regarding the rebates collected and mandates regular updates to maximum allowable cost pricing for prescribed medications.

Contention

One area of debate surrounding SB921 revolves around the inspection into whether PBMs might unintentionally discriminate against covered entities, particularly in regards to the distribution and pricing of 340B drugs, which are critical for many low-income patients. Opponents argue that the bill may not go far enough to protect these entities from unfair pricing practices. Moreover, the potential for increased administrative burden on PBMs due to heightened reporting requirements could spark opposition from those concerned about operational costs and healthcare management efficiency. The legitimacy and enforcement of penalties for violations of the bill's provisions also remain points of contention among stakeholders.