SB236 Alabama 2020 Session

Under existing law, pharmacy benefits managers must be licensed by the Department of Insurance. Pharmacy benefits managers provide claims processing services or prescription drug and other pharmacist services, or both, to health benefit plans

This bill would prohibit pharmacy benefits managers and health benefit plans from transferring and sharing certain patient information with certain affiliates of the pharmacy benefits manager for purposes of steering or referring a patient toward using a specific pharmacy

This bill would prohibit a health benefit plan from requiring an insured to obtain pharmacist services, including prescription drugs, exclusively from a mail-order pharmaceutical distributor or affiliated pharmacy

This bill would prohibit a pharmacy benefits manager from limiting certain powers of a pharmacist to provide pharmacist services to insureds, from steering insured patients toward an affiliated pharmacy, and from sharing patient data with an affiliated pharmacy

This bill would require pharmacy benefits managers to report annually to clients information on pharmacy manufacturer rebates they received

This bill would also provide conforming changes to definitions and would provide civil penalties for violations

Relating to pharmacy benefits managers; to amend Sections 3 through 5 of Act 2019-457, 2019 Regular Session, now appearing as Sections 27-45A-3, 27-45A-4, and 27-45A-5, and 27-45A-6, Code of Alabama 1975; to amend and renumber Section 6 of Act 2019-457, 2019 Regular Session, now appearing as Section 27-45A-6, Code of Alabama 1975; to renumber Section f Act 2019-457, 2019 Regular Session, now appearing as Section 27-45A-7, Code of Alabama 1975; and to add Sections 27-45A-6, 27-45A-7, 27-45A-8, 27-45A-9, 27-45A-10, and 27-45A-12 to the Code of Alabama 1975; to prohibit pharmacy benefits managers and health benefit plans from steering or referring a patient toward using a specific pharmacy; to prohibit health benefits plans from requiring the use of mail-order pharmaceutical distributor or affiliated pharmacies for prescription drugs; to restrict pharmacy benefits managers from steering patients to affiliated pharmacies; to restrict pharmacy benefits managers from mining patient data; to require certain reporting of drug rebates by pharmacy benefits managers; to make conforming changes to definitions; and to provide civil penalties for certain violations.