Reimbursement -- Prohibitions.

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  • (1) This section applies to a contract entered into or renewed on or after January 1, 2021, between a pharmacy benefit manager and a pharmacy.
  • (2) A pharmacy benefit manager may not vary the amount it reimburses a pharmacy for a drug on the basis of whether:
    • (a) the drug is a 340B drug; or
    • (b) the pharmacy is a 340B entity.
  • (3) Subsection (2) does not apply to a drug reimbursed, directly or indirectly, by the Medicaid program.
  • (4) A pharmacy benefit manager may not:
    • (a) on the basis that a 340B entity participates, directly or indirectly, in the 340B drug discount program:
      • (i) assess a fee, charge-back, or other adjustment on the 340B entity;
      • (ii) restrict access to the pharmacy benefit manager's pharmacy network;
      • (iii) require the 340B entity to enter into a contract with a specific pharmacy to participate in the pharmacy benefit manager's pharmacy network;
      • (iv) create a restriction or an additional charge on a patient who chooses to receive drugs from a 340B entity; or
      • (v) create any additional requirements or restrictions on the 340B entity; or
    • (b) require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the Medicaid program.




Technically renumbered to avoid duplication of section number also enacted in HB272, Chapter 198.


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