Pharmacy benefits.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Chaptered
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed Assembly
- To Governor
- Became Law
Overview
This bill aims to regulate pharmacy benefit managers (PBMs) in California to ensure fairer pricing and access to prescription drugs. It prohibits PBMs from requiring use of only affiliated pharmacies, imposing discriminatory practices, and using spread pricing. The bill also requires PBMs to use a passthrough pricing model and be licensed by the Department of Managed Health Care, while limiting their income to pharmacy benefit management fees. Furthermore, it establishes rules regarding cost sharing calculations and transparency in drug pricing.
Key provisions
- Prohibits PBMs from requiring use of only affiliated pharmacies.
- Prohibits PBMs from imposing discriminatory practices against non-affiliated pharmacies.
- Requires PBMs to use a passthrough pricing model.
- Mandates PBM licensing by the Department of Managed Health Care.
- Limits PBM income to pharmacy benefit management fees.
- Prohibits spread pricing arrangements.
- Establishes rules for cost sharing calculations in health insurance policies.
- Requires contracts with PBMs to include licensing and good standing requirements.
Who is affected
- Pharmacy Benefit Managers (PBMs)
- Health Insurers
- California Residents (through impact on prescription drug costs)
- Pharmacies (affiliated and non-affiliated)
- California Department of Managed Health Care
Notable changes
Bill text
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