12 | 13 | | A BILL TO BE ENTITLED 1 |
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13 | 14 | | AN ACT ESTABLISHING FAIR PRICING AND TRANSPARENCY REQUIREMENTS FOR 2 |
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14 | 15 | | 340B COVERED ENTITIES. 3 |
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15 | 16 | | The General Assembly of North Carolina enacts: 4 |
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16 | 17 | | SECTION 1.(a) Chapter 131E of the General Statutes is amended by adding a new 5 |
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17 | 18 | | Article to read: 6 |
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18 | 19 | | "Article 11C. 7 |
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19 | 20 | | "340B Covered Entities. 8 |
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20 | 21 | | "Part 1. Fair Pricing of 340B Drugs by Hospitals. 9 |
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21 | 22 | | "§ 131E-214.50. Definitions. 10 |
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22 | 23 | | The following definitions apply in this Part: 11 |
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23 | 24 | | (1) 340B drug. – A drug that meets the definition of a "covered drug" under 42 12 |
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24 | 25 | | U.S.C. § 256b(b)(2). 13 |
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25 | 26 | | (2) 340B Program. – The federal 340B Drug Pricing Program authorized under 14 |
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26 | 27 | | 42 U.S.C. § 256b and 42 C.F.R. Part 10, as both are from time to time 15 |
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27 | 28 | | amended. 16 |
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28 | 29 | | (3) Acquisition cost. – The amount paid by a covered entity to acquire a 340B 17 |
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29 | 30 | | drug. 18 |
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30 | 31 | | (4) Covered entity. – Any entity described in 42 U.S.C. § 256b(a)(4)(L) or 42 19 |
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31 | 32 | | U.S.C. § 256b(a)(4)(M). 20 |
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32 | 33 | | "§ 131E-214.52. Fair pricing of 340B drugs by hospitals. 21 |
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33 | 34 | | A covered entity that acquires a 340B drug for a discounted price under the 340B Program 22 |
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34 | 35 | | shall not accept an amount greater than the acquisition cost for the 340B drug as payment for 23 |
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35 | 36 | | dispensing, administering, or otherwise delivering the 340B drug to a patient. 24 |
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36 | 37 | | "§ 131E-214.54. Violations constitute unfair or deceptive trade practice. 25 |
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37 | 38 | | Any violation of this Part constitutes an unfair or deceptive trade practice in violation of 26 |
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38 | 39 | | G.S. 75-1.1 and is subject to all of the enforcement and penalty provisions of an unfair or 27 |
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39 | 40 | | deceptive trade practice under Article 1 of Chapter 75 of the General Statutes. 28 |
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40 | 41 | | "Part 2. 340B Covered Entity Transparency. 29 |
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41 | 42 | | "§ 131E-214.60. Definitions. 30 |
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42 | 43 | | The following definitions apply in this Part: 31 |
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43 | 44 | | (1) 340B drug. – A covered outpatient drug that has been subject to any offer for 32 |
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44 | 45 | | reduced prices by a manufacturer pursuant to 42 U.S.C. § 256b, and is 33 |
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45 | 46 | | purchased by a covered entity. 34 |
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46 | 47 | | (2) 340B pricing. – Any price offered by a manufacturer to a covered entity for a 35 |
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49 | 54 | | (3) 340B Program. – The federal 340B Drug Pricing Program authorized under 1 |
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50 | 55 | | 42 U.S.C. § 256b and 42 C.F.R. Part 10, as both are from time to time 2 |
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51 | 56 | | amended. 3 |
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52 | 57 | | (4) Charity care. – The costs reported on Form CMS-2552-10, Worksheet S–10, 4 |
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53 | 58 | | Line 23 or any successor form. 5 |
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54 | 59 | | (5) Covered entity. – A covered entity, as defined in 42 U.S.C. § 256b(a)(4). 6 |
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55 | 60 | | (6) Covered outpatient drug. – A covered outpatient drug, as defined in 42 U.S.C. 7 |
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56 | 61 | | § 1396r-8(k)(2). 8 |
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57 | 62 | | "§ 131E-214.62. Annual reporting requirements. 9 |
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58 | 63 | | (a) Annually by October 1, each covered entity shall report to the Department, in the form 10 |
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59 | 64 | | and manner required by the Department, the following information regarding the preceding 11 |
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60 | 65 | | calendar year for the covered entity and each offsite outpatient facility, clinic, eligible offsite 12 |
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61 | 66 | | location, or other site associated with the covered entity: 13 |
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62 | 67 | | (1) Delineated by form of insurance or payor type, including, but not limited to, 14 |
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63 | 68 | | Medicaid, Medicare, commercial insurance, and uninsured: 15 |
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64 | 69 | | a. Aggregate acquisition cost paid for all 340B drugs. 16 |
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65 | 70 | | b. Aggregate payments received by individuals, insurers, or payors for 17 |
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66 | 71 | | all 340B drugs. For the purpose of this sub-subdivision, aggregate 18 |
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67 | 72 | | payments include cost-sharing amounts. 19 |
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68 | 73 | | c. The total number of prescriptions and what percentage of the covered 20 |
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69 | 74 | | entity's prescriptions were filled with 340B drugs. 21 |
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70 | 75 | | (2) Attestation as to whether the covered entity did any of the following: 22 |
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71 | 76 | | a. Passed on 340B Program discounts to patients of the covered entity in 23 |
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72 | 77 | | the form of lower cost-sharing for 340B drugs at the point of 24 |
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73 | 78 | | dispensing or administration. 25 |
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74 | 79 | | b. Provided a sliding fee scale for 340B drugs for patients whose family 26 |
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75 | 80 | | income is less than two hundred percent (200%) of the federal poverty 27 |
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76 | 81 | | level established pursuant to 42 U.S.C. § 9902. 28 |
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77 | 82 | | (3) Total operating costs of the covered entity, including itemized costs, for each 29 |
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78 | 83 | | of the following: 30 |
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79 | 84 | | a. Implementation of the policies described in subdivision (2) of this 31 |
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80 | 85 | | subsection, if applicable. 32 |
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81 | 86 | | b. Charity care. 33 |
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82 | 87 | | (4) Total payments made by the covered entity or any agent of the covered entity 34 |
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83 | 88 | | to any of the following: 35 |
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84 | 89 | | a. Any pharmacies under contract with the covered entity to dispense 36 |
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85 | 90 | | 340B drugs for 340B program-related services and other functions. 37 |
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86 | 91 | | b. Third-party administrators, including pharmacy benefits managers, for 38 |
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87 | 92 | | managing any components of the covered entity's participation in the 39 |
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88 | 93 | | 340B Program. 40 |
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89 | 94 | | c. Any other third parties in connection with 340B program-related 41 |
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90 | 95 | | compliance, legal, educational, or administrative costs. 42 |
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91 | 96 | | (5) Total number of pharmacies under contract with the covered entity to dispense 43 |
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92 | 97 | | 340B drugs, and among those, the following information: 44 |
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93 | 98 | | a. The number of pharmacies located out-of-state and the states in which 45 |
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94 | 99 | | the out-of-state pharmacies are located. 46 |
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95 | 100 | | b. Total number of prescriptions and orders for 340B drugs filled by the 47 |
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96 | 101 | | covered entity and by each offsite outpatient facility associated with 48 |
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97 | 102 | | the covered entity, and the percentage of such prescriptions or orders 49 |
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98 | 103 | | that were filled at such pharmacies, delineated by in-State and 50 |
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99 | 104 | | out-of-state pharmacies. 51 General Assembly Of North Carolina Session 2025 |
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101 | 106 | | c. Total remuneration paid to or retained by such pharmacies or their 1 |
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102 | 107 | | affiliates for any 340B program-related services performed on behalf 2 |
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103 | 108 | | of the covered entity and each offsite outpatient facility associated 3 |
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104 | 109 | | with the covered entity. 4 |
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105 | 110 | | d. The percentage change in remuneration described in sub-subdivision 5 |
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106 | 111 | | (4)c. of this subsection for the preceding calendar year compared to 6 |
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107 | 112 | | the year before that. 7 |
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108 | 113 | | (b) An officer of the covered entity shall certify to the completeness and accuracy of the 8 |
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109 | 114 | | report submitted pursuant to subsection (a) of this section. 9 |
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110 | 115 | | "§ 131E-214.64. Posting of annual reports. 10 |
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111 | 116 | | The Department shall make all the reports received by covered entities pursuant to 11 |
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112 | 117 | | G.S. 131E-214.62 available to the public on the Department's internet website." 12 |
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113 | 118 | | SECTION 1.(b) Part 1 of Article 11C of Chapter 131E of the General Statutes, as 13 |
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114 | 119 | | enacted by this section, applies to any covered drug, as defined by 42 U.S.C. § 256b(b)(2), that 14 |
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115 | 120 | | is dispensed, administered, or otherwise delivered to a patient by a covered entity on or after the 15 |
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116 | 121 | | date this act becomes law. As used in this subsection, the term "covered entity" has the same 16 |
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117 | 122 | | meaning as in G.S. 131E-214.50. 17 |
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118 | 123 | | SECTION 1.(c) Covered entities subject to Part 2 of Article 11C of Chapter 131E 18 |
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119 | 124 | | of the General Statutes, as enacted by this section, shall submit the first report due under 19 |
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120 | 125 | | G.S. 131E-214.62 by October 1, 2026. 20 |
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121 | 126 | | SECTION 2. This act is effective when it becomes law. 21 |
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