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