HB 3409
Allows insurers offering policies or certificates of health insurance and pharmacy benefit managers to require that a claim for reimbursement of a prescription drug include a modifier or other indicator that the drug is a 340B drug unless certain requirements are met.
Jurisdiction
Oregon
Session
2025 Regular Session
At the request of
(at the request of Representative Ben Bowman)
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Sign in to take actionPublic sentiment
Support
36%
Oppose
64%
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Bill overview
This bill requires insurers and pharmacy benefit managers in Oregon to include a specific modifier or indicator on prescription drug claims if the drug is a 340B drug. This aims to ensure that 340B discounts are properly accounted for. The bill also directs the Oregon Health Authority to study healthcare issues and sunsets after a specified period. It modifies existing tax law regarding deductions for medical expenses.
Key provisions
- Insurers and pharmacy benefit managers must include a modifier on prescription drug claims to indicate if the drug is a 340B drug.
- The Oregon Health Authority must conduct a study on healthcare issues and submit findings to the Legislative Assembly.
- The bill amends Oregon Revised Statute (ORS) 316.693 to adjust deductions for medical expenses based on age and federal adjusted gross income.
- The maximum subtraction for medical expenses is capped at $5,600 for a joint return or $2,800 for an individual.
- The maximum subtraction is adjusted annually based on the Consumer Price Index.
- The bill specifies the effective dates for the changes to ORS 316.693 and the study by the Oregon Health Authority.
Who is affected
- Insurers
- Pharmacy Benefit Managers
- Prescription Drug Consumers
- Healthcare Providers
- Taxpayers
Notable changes
- Introduces a requirement for insurers and PBMs to identify 340B drugs on claims.
Sponsors
Official sponsors from legislative records.
Primary sponsor
House Committee On Rules
Arguments in favor
Reasons to support this legislation.
Supporters of House Bill 3409-2 argue that the bill offers a more workable approach to the 340B program, providing providers with an option to use a third-party clearinghouse to validate and report claims after the fact. Additionally, proponents see value in the bill's requirement for Federally Qualified Health Centers to report necessary data to interested parties, aiming to prevent double payments and ensure transparency in 340B claim modifiers. The bill is also seen as crucial in protecting the 340B program, ensuring essential community health services are available to patients in rural and underinvested areas, where access to discounted medication and care is particularly vital. Furthermore, supporters of House Bill 2385 recognize the need to address discriminatory reimbursement practices from pharmacy benefit managers and third-party payers, which they believe the bill aims to address.
Source: Testimony Summaries
Arguments opposed
Reasons to oppose this legislation.
Opponents of HB 3409 as amended express concerns about the potential for unvetted claims reporting and abuse within the 340B program. They argue that prohibiting the use of 340B 'claims modifiers' could increase the risk of duplicate discounts and diversion, undermining program integrity. Critics also contend that the amendment would impede efforts to improve program integrity through increased transparency, fail to advance long-term sustainability, and negatively impact the pharmaceutical industry's ability to assist patients. Furthermore, opponents believe the amendment would undermine federal prohibitions against duplicate discounts and diversion, ultimately working against the interests of Oregon's patients, employers, workers, and taxpayers.