13RS SB107
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SB107

13RS

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SB 107 (BR 863) - J. Denton, W. Blevins Jr., D. Harper Angel, J. Higdon, J. Rhoads, J. Turner

     AN ACT relating to pharmacy benefit managers.
     Create a new section of Subtitle 17A of KRS Chapter 304 to define the terms "contracted pharmacy," "drug product reimbursement," and "pharmacy benefit manager"; require a pharmacy benefit manager to include the methodology used to calculate drug product reimbursements; establish certain requirements when a maximum allowable cost is used to determine a drug product reimbursement, including information identifying the national drug pricing compendia or source used to obtain the drug price, making the list of drugs subject to the MAC, and reviewing and making adjustments to the maximum allowable cost at least once per week; make those weekly updates available to contracted pharmacies; and provide a process for the MAC to be appealed.

SB 107 - AMENDMENTS


     SCS - Delete original provisions; create a new section of Subtitle 17A of KRS Chapter 304 to define terms, including the definition of "contracted pharmacy" that requires that the contracted pharmacy be located in Kentucky; require contracts between PBMs and pharmacies to include sources used by the PBM to calculate the drug product reimbursement; require a process that will appeal, investigate, and resolve disputes; specify length of time to raise an appeal and to investigate and resolve it; require that the national drug code of a drug that can be purchased by the contracted pharmacy at or below the MAC cost be provided when an appeal is denied, require that a process for retroactive reimbursements be included in PBM and pharmacy contracts within one year; require the PBM to include national drug pricing compendia or sources used to obtain drug price data when a MAC is established for a drug; require the drugs subject to MAC and the MAC for each drug be provided to each contracted pharmacy; require review and necessary adjustments to the MAC at least every 14 days; require weekly updates to the list of drugs subject to the MAC.
     SFA (1, J. Denton) - Retain original provisions, except remove the requirement to disclose the methodology to determine the MAC, extend the requirement to review the MAC to once every two weeks, require appeals to be completed within 10 days, and require that the national drug code of a drug that can be purchased by the contracted pharmacy at or below the MAC cost be provided when an appeal is denied.
     SFA (2, J. Higdon) - Retain original provisions, except remove the requirement to disclose the methodology to determine the MAC; extend the requirement to review the MAC to once every two weeks; require appeals to be completed within 10 days; require that the national drug code of a drug that can be purchased by the contracted pharmacy at or below the MAC cost be provided when an appeal is denied.

     Feb 6-introduced in Senate
     Feb 11-to Judiciary (S)
     Feb 12-reassigned to Health & Welfare (S)
     Feb 13-reported favorably, 1st reading, to Calendar
     Feb 14-2nd reading, to Rules
     Feb 22-floor amendment (1) filed
     Feb 25-floor amendment (2) filed
     Feb 27-recommitted to Health & Welfare (S); reported favorably, to Rules with Committee Substitute ; placed in the Orders of the Day; 3rd reading, passed 37-0 with Committee Substitute
     Feb 28-received in House
     Mar 4-to Banking & Insurance (H); posted in committee
     Mar 5-taken from Banking & Insurance (H); 1st reading; returned to Banking & Insurance (H)
     Mar 6-reported favorably, 2nd reading, to Rules; taken from Rules; placed in the Orders of the Day Thursday, March 7, 2013
     Mar 7-3rd reading, passed 96-0; received in Senate; enrolled, signed by President of the Senate
     Mar 11-enrolled, signed by Speaker of the House; delivered to Governor
     Mar 22-signed by Governor (Acts Chapter 109)

Vote History
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