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ARIZONA HOUSE OF REPRESENTATIVESFifty-fifth Legislature Second Regular Session |
Senate: APPROP DP 10-0-0-0 | 3rd Read 28-0-2-0
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SB 1176: tax credit review committee; meetings
S/E: 340B drug programs; prohibitions
Sponsor: Senator Gowan, LD 14
Caucus & COW
Summary of the Strike-Everything Amendment to SB 1176
Overview
Outlines certain prohibitions for a third party that reimburses for 340B drugs.
History
The 340B drug program was established by federal law in order to enable covered entities to stretch scarce federal resources as far as possible. Manufacturers that participate in Medicaid agree to provide outpatient drugs to covered entities at a significantly reduced price. The health care organizations and covered entities that are eligible to participate are defined in federal statute and include Health Resources and Services Administration supported health centers, children's hospitals and other safety net providers (HRSA).
Provisions
1. Stipulates that the provisions apply to third parties that manage or provide drug coverage under a health care plan in Arizona. (Sec. 1)
2. States that the provisions do not apply to the Arizona Health Care Cost Containment System (AHCCCS) administration and its contractors to the extent services are provided pursuant to statute relating to AHCCCS, behavioral health services or equivalent Medicaid programs from other states. (Sec. 1)
3. Prohibits a third party that reimburses for 340B drugs from doing any of the following:
a) Reimbursing at rates for 340B drugs lower than the rates reimbursed for the same non 340B drug at a pharmacy similar in prescription volume;
b) Assessing any clawback, fee, adjustment, chargeback or other assessment on the basis that a drug is a 340B drug;
c) Restricting access to any of the third party's pharmacy networks on the basis that the pharmacy dispenses 340B drugs;
d) Requiring the 340B covered entity to enter into a contract with a health care plan or specific pharmacy to participate in the third party's pharmacy network;
e) Establishing additional charges or restrictions on patients who choose to receive 340B drugs;
f) Restricting the pharmacies or methods by which a 340B covered entity may dispense or deliver 340B drugs;
g) Refusing to provide coverage or reimbursement for 340B drugs; or
h) Establishing restrictions or additional requirements only on 340B drugs. (Sec. 1)
4. States that a pharmacy benefit manager or other third party that pays for the drugs, with respect to a patient who is eligible to receive drugs subject to an agreement under federal law, may not discriminate against a 340B covered entity in a way that interferes with or prevents the patient's choice to receive the drugs or that interferes with the ability of a covered entity to maximize the value of discounts provided under the 340B drug discount program. (Sec. 1)
5. Directs the Department of Insurance and Financial Institutions to adopt rules to implement the provisions. (Sec. 1)
6. Specifies that the adopted rules must set forth penalties, including monetary penalties, for violations of the provisions and the adopted rules. (Sec. 1)
7. Declares that a violation of any of the provisions by a third party constitutes a deceptive or an unfair act or practice in the business of insurance and is considered unenforceable and void. (Sec. 1)
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Defines pertinent terms. (Sec. 1)
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12. SB 1176
13. Initials SJ Page 0 Caucus & COW
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