Section 309 – Reimbursement — Prohibitions.

• (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.

Enacted by Chapter 275, 2020 General Session

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