The Colorado General Assembly has passed a bill setting minimum rates for what pharmacy benefit managers can pay to a pharmacy for prescription drugs.
The new bill, passed May 10, applies to contracts starting Jan. 1 between a PBM and a pharmacy that is located in a county with a population of fewer than 100,000 people and owned by a licensed pharmacist.
The Colorado Association of Health Plans opposed the legislation, saying it will raise premium prices, according to The Colorado Sun.
Included in the bill:
- PBMs cannot reimburse a pharmacy for a prescription drug in an amount less than the national average drug acquisition cost.
- Payers and PBMs cannot discriminate against entities participating in the federal 340B drug pricing program, including a pharmacy that contracts with a 340B covered entity to provide dispensing services.
- Third-party payers cannot refuse to reimburse a 340B covered entity or contract pharmacy for dispensing 340B drugs, impose additional requirements or restrictions on 340B covered entities or contract pharmacies, or reimburse a 340B covered entity or contract pharmacy for a 340B drug at a rate lower than the amount paid for the same drug to pharmacies that are not 340B covered entities or contract pharmacies.
- Third-party payers cannot assess a fee, chargeback, or make another adjustment against a 340B covered entity or contract pharmacy or restrict a 340B covered entity's or contract pharmacy's access to the payer's pharmacy network because the 340B covered entity or contract pharmacy participates in the 340B drug pricing program.
- Third-party payers cannot require a 340B covered entity or contract pharmacy to contract with a specific pharmacy or health plan to access the third-party payer's pharmacy network.
- Third-party payers cannot impose a restriction or an additional charge on a patient who obtains a prescription drug from a 340B covered entity or contract pharmacy or restrict the methods by which a 340B covered entity or contract pharmacy may dispense or deliver 340B drugs.