State legislatures are coming for PBMs

Over the last year, state legislatures across the country have introduced and passed laws aimed at regulating and creating more transparency around pharmacy benefit managers, according to JDSupra.

In 2021 alone, 18 states passed or will have legislation become effective involving PBM licensing or registration requirements:

Alabama — SB 227 (effective July 2021)

Alabama — Rule and Regulation 482-1-164-.01 (effective January 2022)

Delaware — HB 219 (effective October 2021)

Georgia — Rule and Regulation 120-2-97-.01 (effective January 2021)

Hawaii — SB 1096 (effective June 2021)

Indiana — HB 1405 (effective April 2021)

Kentucky — Rules and Regulation 806 KAR 9:360 (amendment effective July 2021)

Maine — Rule and Regulation Chapter 210 (effective February 2021)

Maryland — HB 601 (effective January 2022)

Maryland — Bulletin 21-07 (effective March 2021)

Minnesota — Insurance Code 62W.11 (amendment effective July 2021)

Mississippi — Rules and Regulations R30-3001-4501 (amendment effective December 2021)

Missouri — Rule and Regulation 20 CSR 200-22.010 (effective October 2021)

Montana — SB 395 (effective January 2022)

Montana — Rule and Regulation dated Oct. 12, 2021 (effective October 2021)

New Hampshire — Bulletin 21-001-AB (effective January 2021)

New Hampshire — Bulletin 21-104-AB (effective December 2021)

New Mexico — Rules and Regulation 13.10.30.9 (effective March 2021)

North Carolina — SB 257 (effective October 2021)

Oklahoma — HB 2677 (effective May 2021)

South Carolina — Bulletin 2021-08 (effective December 2021)

Washington — Insurance Code 48.200.010 (effective January 2022)

Washington — Rules and Regulations 284-180-110 (effective January 2022).

New York created the Department of Financial Services' Pharmacy Benefits Bureau in early May, an office tasked with licensing and regulating the state's pharmacy benefits industry. Pharmacy benefit managers operating in the state will be required to register with the new bureau by June 1 and submit their first annual report by July 1.

New Jersey also now requires registration of PBMs as organized delivery systems, or companies that provide healthcare services or provide a network of providers, according to JDSupra.

Bipartisan legislation was also introduced May 24 in the Senate that would allow the Federal Trade Commission to increase drug pricing transparency and suppress pharmacy benefit manager practices such as spread pricing and payment clawbacks.

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