HB 3212
Creates additional rules and requirements for pharmacy benefit managers and a policy or certificate of health insurance or other contract providing for the reimbursement of the cost of a prescription drug.
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Sign in to take actionPublic sentiment
Support
89%
Oppose
11%
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill aims to increase oversight and regulation of pharmacy benefit managers (PBMs) and the reimbursement process for prescription drugs in Oregon. It introduces new rules for PBMs regarding drug lists, maximum allowable costs, and contract terms, with the goal of ensuring fair pricing and access to medications. The bill also establishes a process for pharmacies to appeal reimbursement decisions and clarifies rules related to 340B drugs and pharmacy networks.
Key provisions
- Establishes new rules and requirements for pharmacy benefit managers (PBMs).
- Requires PBMs to make detailed information about their drug pricing methods available to network pharmacies.
- Mandates that PBMs maintain updated lists of drugs with maximum allowable costs and make them accessible to pharmacies.
- Creates a process for network pharmacies to appeal reimbursement decisions.
- Prohibits PBMs from imposing certain fees or restrictions on pharmacies.
- Clarifies rules regarding 340B drugs and their reimbursement.
- Requires PBMs to offer the same contract terms to network and out-of-network pharmacies.
- Establishes a process for pharmacies to file complaints against PBMs regarding reimbursement disputes.
Who is affected
- Pharmacy Benefit Managers (PBMs)
- Health Insurance Companies
- Pharmacies
- Prescription Drug Consumers
- Oregon Residents
Notable changes
Sponsors
Official sponsors from legislative records.
Primary sponsors
Gregory Smith
Arguments in favor
Reasons to support this legislation.
Supporters of House Bill 3212 advocate for fairness, transparency, and improved healthcare outcomes by regulating Pharmacy Benefit Managers (PBMs) in Oregon. They express concerns about PBMs' impact on pharmacy closures, long lines/wait times, and high costs, as well as patient rationing and limited access to medication affordability. Proponents argue that the bill aims to bring transparency to PBM operations, ensure fair reimbursement rates for pharmacies, and promote patient choice and competition. Many the need to safeguard patient rights, prevent corporate profits from driving out local pharmacies, and ensure access to quality healthcare services. They believe that HB 3212 will address Oregon's pharmacy access crisis by regulating PBMs and promoting a more sustainable model for independent pharmacies.
Source: Testimony Summaries
Arguments opposed
Reasons to oppose this legislation.
Opponents of House Bill 3212 express concerns that the bill's lack of consumer protection language and proposed changes to professional dispensing fees and pharmacy network contracting would lead to increased financial burdens on patients, forcing them to choose between their health and financial stability. They also argue that the bill lacks clarity on how dispensing fees would be determined and would result in higher prices at the pharmacy counter, negatively impacting member affordability and access to prescription drugs. Furthermore, organizations such as CareOregon and the Association of Oregon Counties express concerns about the potential financial consequences of the bill, including increased costs for counties and insurers that would be passed down to employees through higher insurance premiums.