Registering and Regulating Pharmacy Benefit Managers

H.3159 is a reintroduction of last session’s H.3151. The bill would require the registration and regulation of pharmacy benefit managers (PBM), defined as an individuals who engage in “the administration or management of prescription drug benefits provided by a covered entity (most health coverage plans in South Carolina) for the benefit of a covered individual”. The legislation would restrict PBMs from: discriminating when contracting with any pharmacy, attempting to influence a prescriber’s choice of therapy, attempting to influence a patient’s choice of pharmacist, or switching a prescribed drug without the express authorization of the prescriber. PBMs would also be required to make certain financial data available for review to covered entities. The bill also lays out the process and regulatory framework for audits of pharmacists or pharmacy records.

It’s worth noting that this bill and last session’s H.3151 were both filed by Representative Kit Spires (R. Lexington), a pharmacist who has a record of filing bills related to the pharmaceutical industry, some of which could prove financially beneficial to himself.

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