Relating to pharmacy benefits; declaring an emergency.
Impact
The implications of HB 3013 on state laws will be significant, particularly in enhancing accountability for pharmacy benefit managers and improving access to medications for consumers. By ensuring that policies governing the reimbursement of prescription drugs allow consumers to choose their pharmacies freely, the bill aims to promote a competitive environment which benefits patients. Further, it seeks to ensure that pharmacies are not subjected to unreasonable audits which can hamper their operations. These changes are anticipated to foster a more equitable healthcare system in Oregon as the coverage for specific medications becomes more consumer-friendly.
Summary
House Bill 3013 aims to regulate pharmacy benefit managers (PBMs) by requiring them to be licensed by the Department of Consumer and Business Services starting January 1, 2024. The bill modifies the definition of a pharmacy benefit manager and imposes stricter requirements concerning their operations. This includes setting parameters for how pharmacies can appeal payment decisions made by PBMs and restricting the frequency and manner of audits that PBMs can conduct on pharmacies. The legislation emphasizes transparency and fair practices regarding drug reimbursement procedures particularly for prescriptions and the coverage of 340B drugs, which pharmacies acquire at reduced prices for eligible patients.
Sentiment
The general sentiment surrounding HB 3013 appears to be positive among advocates for consumer rights in healthcare. Supporters argue that the legislation is necessary to curb the excesses of PBMs that often lead to higher prices and access issues for patients. However, there may be concerns from some stakeholders regarding the additional regulatory burden that these changes could impose on pharmacy benefit managers and how this might affect the pricing structure of medications in the state. The bill has garnered support from legislators who prioritize healthcare accessibility and affordability.
Contention
Despite the perceived benefits, there are potential points of contention that could arise from this legislation. Some pharmacy benefit managers may view the new licensing and regulatory requirements as an encroachment on their business practices that could lead to increased costs. Additionally, the potential impact on PBM negotiations with manufacturers and insurers could alter the landscape of drug pricing and availability in Oregon. Balancing the interests of PBMs with the need for consumer protection will likely be a focal point of discussion as the bill moves through the legislative process.
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.
Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)
Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)
Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)