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Healthcare

SB489

To Amend The Law Concerning Maximum Allowable Cost Lists To Define A Similarly Situated Pharmacy, Clarify How A Pharmacy Benefits Manager Provided Its Maximum Allowable Cost List, And Establish A Private Right Of Action.

Introduced

Last Action (March 27, 2023): Sine Die adjournment

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AI-Generated Summary

Senate Bill 489 amends Arkansas law concerning Maximum Allowable Cost (MAC) lists used by pharmacy benefits managers (PBMs). It defines a 'similarly situated pharmacy' to standardize how reimbursement changes are applied across competing pharmacies. The bill mandates that PBMs provide their MAC lists to pharmacies in a clear, observable format comparable to the national average drug acquisition cost list. It also clarifies that updates to reimbursement rates must be applied effectively to all similarly situated pharmacies. Finally, the bill establishes a private right of action, allowing pharmacists and pharmacies to pursue legal claims under specific state trade and licensure laws for violations regarding MAC list practices, prohibiting these rights from being waived by contract.

Potential Impact Analysis

Who Might Benefit?

Independent pharmacies and pharmacists are the primary beneficiaries, as the bill provides them with greater transparency in reimbursement pricing, more consistent application of rate changes, and legal standing to hold pharmacy benefits managers accountable for regulatory violations.

Who Might Suffer?

Pharmacy benefits managers (PBMs) are the primary entities negatively impacted, as the legislation imposes stricter disclosure requirements, limits their operational flexibility in applying reimbursement changes, and exposes them to increased legal liability and private litigation through the establishment of a non-waivable private right of action.

Read Full Bill on arkleg.state.ar.us