SB1205112th GA (Historical)Introduced

Amends TCA Title 4; Title 56 and Title 71.

This bill prohibits health insurance issuer, managed health insurance issuer, pharmacy benefits manager, or other third-party payer from discriminating against 340B entities by: (1) Reimbursing 340B entities for pharmacy-dispensed drugs at a rate lower than the rate paid for the same drug by national drug code number to pharmacies that are not 340B entities; (2) Assessing a fee, chargeback, or adjustment upon a 340B entity that is not equally assessed on non-340B entities; or (3) Excluding 340B entities from its network of participating pharmacies based on criteria that is not applied to non-340B entities. This bill also prohibits a pharmacy benefits manager or third party that makes payment for drugs that a patient is eligible to receive subject to an agreement under the federal Public Health Service Act from discriminating against a 340B entity in a manner that prevents or interferes with the patient's choice to receive those drugs from the 340B entity. This bill does not apply to the TennCare, CoverKids, or Volunteer RX programs. For purposes of this bill, "340B entity" means a covered entity participating in the federal 340B drug discount program, as defined in section 340B of the federal Public Health Service Act, including the entity's pharmacy or pharmacies, or any pharmacy or pharmacies under contract with the 340B covered entity to dispense drugs on behalf of the 340B covered entity. This bill takes effect October 1, 2021. ON MARCH 29, 2021, THE HOUSE ADOPTED AMENDMENT #1 AND PASSED HOUSE BILL 1348, AS AMENDED. AMENDMENT #1 adds a prohibition against a health insurance issuer, managed health insurance issuer, pharmacy benefits manager, or other third-party payer require that a claim for a drug by national drug code number include a modifier to identify that the drug is a covered drug.

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Overview

This bill prohibits health insurance issuer, managed health insurance issuer, pharmacy benefits manager, or other third-party payer from discriminating against 340B entities by: (1) Reimbursing 340B entities for pharmacy-dispensed drugs at a rate lower than the rate paid for the same drug by national drug code number to pharmacies that are not 340B entities; (2) Assessing a fee, chargeback, or adjustment upon a 340B entity that is not equally assessed on non-340B entities; or (3) Excluding 340B entities from its network of participating pharmacies based on criteria that is not applied to non-340B entities. This bill also prohibits a pharmacy benefits manager or third party that makes payment for drugs that a patient is eligible to receive subject to an agreement under the federal Public Health Service Act from discriminating against a 340B entity in a manner that prevents or interferes with the patient's choice to receive those drugs from the 340B entity. This bill does not apply to the TennCare, CoverKids, or Volunteer RX programs. For purposes of this bill, "340B entity" means a covered entity participating in the federal 340B drug discount program, as defined in section 340B of the federal Public Health Service Act, including the entity's pharmacy or pharmacies, or any pharmacy or pharmacies under contract with the 340B covered entity to dispense drugs on behalf of the 340B covered entity. This bill takes effect October 1, 2021. ON MARCH 29, 2021, THE HOUSE ADOPTED AMENDMENT #1 AND PASSED HOUSE BILL 1348, AS AMENDED. AMENDMENT #1 adds a prohibition against a health insurance issuer, managed health insurance issuer, pharmacy benefits manager, or other third-party payer require that a claim for a drug by national drug code number include a modifier to identify that the drug is a covered drug.

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Sponsor

Unknown

Details
Session

112th General Assembly

Introduced

February 11, 2021

Subjects
366024302415217014660913

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SB1205: Amends TCA Title 4; Title 56 and Title 71. | LegisGo