SB252 Alabama 2025 Session

Summary

Primary Sponsor

William “Bill” M. Beasley Senator

Democrat

Session

2025 Regular Session

Title

Pharmacy Benefits Managers; providing a prescription reimbursement rate for independent pharmacies and regulating other practices

Description

This bill, known as "The Community Pharmacy Relief Act," would further regulate pharmacy benefits managers.

Pharmacy benefits managers are third-party administrators of prescription drug benefits in a health insurance plan. They are primarily responsible for processing and paying prescription drug claims.

They typically negotiate price discounts and rebates from manufacturers and determine how pharmacies get reimbursed for dispensing the prescription drugs. Under state law, pharmacy benefits managers are licensed and regulated by the Department of Insurance.

This bill would prohibit pharmacy benefits managers from reimbursing independent pharmacies less than the amount paid by the Alabama Medicaid Agency to pharmacies for prescription drugs for a period of two years.

This bill would prohibit pharmacy benefits managers from charging pharmacies or pharmacists miscellaneous fees related to network participation and claims processing, and from charging other fees that reduce reimbursement or increase out-of-pocket charges to health plan beneficiaries.

Pharmacy benefits managers would be prohibited SB252 INTRODUCED under this bill from barring disclosure of information by pharmacists to consumers about drug costs and alternative drugs for treatment.

Pharmacy benefits managers would be further required to pass on 100 percent of rebates received from drug manufacturers to the health benefit plans for which they provide services.

This bill would specify that the Commissioner of Insurance shall enforce violations by a pharmacy benefits manager, including those committed during an audit of a pharmacy under the Pharmacy Audit Integrity Act, and would provide a civil penalty.

This bill would provide a civil action for pharmacists, pharmacies, and insurance beneficiaries for injuries due to violations by a pharmacy benefits manager.

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Subjects

Insurance