| 1 | 1 | | FIRSTREGULARSESSION |
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| 2 | 2 | | HOUSEBILLNO.784 |
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| 3 | 3 | | 103RDGENERALASSEMBLY |
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| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEPETERS. |
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| 5 | 5 | | 1554H.01I JOSEPHENGLER,ChiefClerk |
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| 6 | 6 | | ANACT |
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| 7 | 7 | | Toamendchapter376,RSMo,byaddingtheretoonenewsectionrelatingtopaymentsfor |
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| 8 | 8 | | prescriptiondrugs,withpenaltyprovisions. |
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| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 10 | 10 | | SectionA.Chapter376,RSMo,isamendedbyaddingtheretoonenewsection,tobe |
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| 11 | 11 | | 2knownassection376.417,toreadasfollows: |
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| 12 | 12 | | 376.417.1.Asusedinthissection,thefollowingtermsmean: |
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| 13 | 13 | | 2 (1)"340Bdrug",thesamemeaninggiventotheterminsection376.414; |
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| 14 | 14 | | 3 (2)"Coveredentity",anyentitydescribedinsubparagraphs(A)to(K)of |
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| 15 | 15 | | 4subsection(a)(4)ofSection340BofthePublicHealthServiceAct,42U.S.C.Section |
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| 16 | 16 | | 5256b,includinganypharmacywithwhichsuchentityhascontractedtodispense340B |
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| 17 | 17 | | 6drugsonbehalfoftheentity; |
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| 18 | 18 | | 7 (3)"Healthcarrier",thesamemeaninggiventotheterminsection376.1350; |
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| 19 | 19 | | 8 (4)"Pharmacy",anentitylicensedunderchapter338; |
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| 20 | 20 | | 9 (5)"Pharmacybenefitsmanager",thesamemeaninggiventotheterminsection |
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| 21 | 21 | | 10376.388. |
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| 22 | 22 | | 11 2.Ahealthcarrier,apharmacybenefitsmanager,oranagentoraffiliateofsuch |
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| 23 | 23 | | 12healthcarrierorpharmacybenefitsmanagershallnotdiscriminateagainstacovered |
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| 24 | 24 | | 13entityincluding,butnotlimitedto,bydoinganyofthefollowing: |
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| 25 | 25 | | 14 (1)Reimbursingacoveredentityforaquantityofa340Bdruginanamountless |
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| 26 | 26 | | 15thanitwouldpayanyothersimilarlysituatedpharmacyorentitythatisnotacovered |
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| 27 | 27 | | 16entityforsuchquantityofsuchdrugonthebasisthatthecoveredentityisacovered |
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| 28 | 28 | | 17entityorthatthecoveredentitydispenses340Bdrugs.Thedirectorofthedepartment |
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| 29 | 29 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
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| 30 | 30 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18ofcommerceandinsuranceshallspecifybyrulethecircumstancesunderwhicha |
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| 31 | 31 | | 19pharmacyorentityshallbedeemeda"similarlysituatedpharmacyorentity"for |
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| 32 | 32 | | 20purposesofthissubdivision; |
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| 33 | 33 | | 21 (2)Imposinganytermsorconditionsoncoveredentitiesthatdifferfromsuch |
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| 34 | 34 | | 22termsorconditionsappliedtoothersimilarlysituatedentitiesorpharmaciesthatare |
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| 35 | 35 | | 23notcoveredentitiesonthebasisthatthecoveredentityisacoveredentityorthatthe |
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| 36 | 36 | | 24coveredentitydispenses340Bdrugsincluding,butnotlimitedto,termsorconditions |
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| 37 | 37 | | 25withrespecttoanyofthefollowing: |
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| 38 | 38 | | 26 (a)Fees,chargebacks,clawbacks,adjustments,orotherassessments; |
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| 39 | 39 | | 27 (b)Professionaldispensingfees; |
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| 40 | 40 | | 28 (c)Restrictionsorrequirementsregardingparticipationinstandardor |
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| 41 | 41 | | 29preferredpharmacynetworks; |
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| 42 | 42 | | 30 (d)Requirementsrelatingtothefrequencyorscopeofauditsortoinventory |
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| 43 | 43 | | 31managementsystemsusinggenerallyacceptedaccountingprinciples;and |
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| 44 | 44 | | 32 (e)Anyotherrestrictions,conditions,practices,orpoliciesthat,asspecifiedby |
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| 45 | 45 | | 33thedirectorofthedepartmentofcommerceandinsurance,interferewiththeabilityofa |
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| 46 | 46 | | 34coveredentitytomaximizethevalueofdiscountsprovidedunder42U.S.C.Section |
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| 47 | 47 | | 35256b; |
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| 48 | 48 | | 36 (3)Discriminatinginreimbursementtoacoveredentitybasedonthe |
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| 49 | 49 | | 37determinationorindicationadrugisa340Bdrug; |
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| 50 | 50 | | 38 (4)Requiringacoveredentitytoidentify,eitherdirectlyorthroughathird |
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| 51 | 51 | | 39party,a340Bdrug; |
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| 52 | 52 | | 40 (5)Refusingtocoverdrugspurchasedunderthe340Bdrug-pricingprogram;or |
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| 53 | 53 | | 41 (6)Requiringacoveredentitytoreverse,resubmit,orclarifya340Bdrug- |
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| 54 | 54 | | 42pricingclaimaftertheinitialadjudicationunlesstheseactionsare: |
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| 55 | 55 | | 43 (a)Inthenormalcourseofpharmacybusinessandnotrelatedto340Bdrug |
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| 56 | 56 | | 44pricing;or |
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| 57 | 57 | | 45 (b)Requiredbyfederallaw. |
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| 58 | 58 | | 46 3.Thedirectorofthedepartmentofcommerceandinsuranceshallimposea |
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| 59 | 59 | | 47civilpenaltyonanyhealthcarrier,pharmacybenefitsmanager,oragentoraffiliateof |
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| 60 | 60 | | 48suchhealthcarrierorpharmacybenefitsmanagerthatviolatestherequirementsofthis |
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| 61 | 61 | | 49section.Suchpenaltyshallnotexceedfivethousanddollarsperviolationperday. |
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| 62 | 62 | | 50 4.Thedirectorofthedepartmentofcommerceandinsuranceshallpromulgate |
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| 63 | 63 | | 51rulestoimplementtheprovisionsofthissection.Anyruleorportionofarule,asthat |
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| 64 | 64 | | 52termisdefinedinsection536.010,thatiscreatedundertheauthoritydelegatedinthis |
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| 65 | 65 | | 53sectionshallbecomeeffectiveonlyifitcomplieswithandissubjecttoallofthe |
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| 66 | 66 | | 54provisionsofchapter536and,ifapplicable,section536.028.Thissectionandchapter |
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| 67 | 67 | | HB784 2 55536arenonseverableandifanyofthepowersvestedwiththegeneralassembly |
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| 68 | 68 | | 56pursuanttochapter536toreview,todelaytheeffectivedate,ortodisapproveandannul |
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| 69 | 69 | | 57arulearesubsequentlyheldunconstitutional,thenthegrantofrulemakingauthority |
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| 70 | 70 | | 58andanyruleproposedoradoptedafterAugust28,2025,shallbeinvalidandvoid. |
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| 71 | 71 | | âś” |
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| 72 | 72 | | HB784 3 |
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