SB478-FN: relative to strengthening prescription drug affordability and pharmacy benefits manager accountability.

Related law links

RSA references from bill data

• 402-N · amend · effective 2027-01-01

  rules, pursuant to RSA 541-A, to implement this act, including standardized reporting formats, confidentiality protections, audit standards, and enforcement. II. Penalties under RSA 402-N shall remain administrative and proportionate. No private right of action is created. 4 New Section; Employer Choice and State Plan Alignment. Amend RSA 402-N by inserting after section 2 the following new section:

• 402-N:1 · repeal · effective 2027-01-01

  expand access to biosimilars and other lower-net-cost therapies, and offer consumers optional monthly out-of-pocket smoothing. 2 Pharmacy Benefits Managers; Definitions. Amend RSA 402-N:1 is repealed and reenacted to read as follows: 402-N:1 Definitions. In this chapter: I. "Claims processing services" means the administrative services performed in connection with the processing and adjudicati

• 402-N:2 · repeal · effective 2027-01-01

  ffiliated with a pharmacy benefit manager in cases where the pharmacy benefit manager is a person other than a corporation. 3 Pharmacy Benefits Managers; Rulemaking; Penalties. RSA 402-N:2 is repealed and reenacted to read as follows: 402-N:2 Registration to do Business; Rulemaking; Penalties. I. The commissioner shall adopt rules, pursuant to RSA 541-A, to implement this act, including standardiz

• 402-N:2-A · reference · effective 2027-01-01

  to any action or determination thereunder, which shall be construed and enforced and applied as if such illegal or invalid portion were not contained therein. 11 Applicability. RSA 402-N:2-a, as inserted by section 4 of this act shall apply to contracts issued or renewed on or after January 1, 2027. 12 Effective Date. I. Sections 5-10 of this act shall take effect January 1, 2027. II. The remainde

• 402-N:3 · amend · effective 2027-01-01

  ishable by the department through a civil monetary penalty not to exceed $1,000 per claim. 5 New Paragraphs; Provider Contract Standards for Pharmacy Benefits Managers. Amend RSA 402-N:3 by inserting after paragraph III the following new paragraphs: I. A PBM shall not assess retroactive fees, recoupments, or “DIR”-like adjustments on clean claims after adjudication, except for fraud, waste, abuse, o

• 402-N:4 · amend · effective 2027-01-01

  to facilitate compliance consistent with federal law and privacy protections. 7 New Paragraphs; Prescription Drugs; Formulary Integrity; Biosimilars; Patient Protections. Amend RSA 402-N:4 by inserting after paragraph II the following new paragraphs: III. Pharmacy benefits managers shall support formulary placement based on evidence-based clinical criteria and lowest net cost, including rebates and al

• 402-N:9 · repeal · effective 2027-01-01

  rieved by a violation of this section may bring a civil action before a state court of competent jurisdiction against a pharmacy benefit manager. 10 Preemption; Severability. RSA 402-N:9 is repealed and reenacted to read as follows: 402-N:6-d Preemption; Construction. I. This chapter is intended to regulate insurance and PBM practices within the state to the maximum extent permitted by federal l

• 420-J:3 · reference · effective 2027-01-01

  acists or pharmacies for pharmacist services. II. "Commissioner" means the commissioner of the insurance department. III. "Health carrier" means "health carrier" as defined in RSA 420-J:3, XXIII. IV. "Pharmacist" means an individual licensed as a pharmacist by the pharmacy board. V. "Pharmacist services" means products, goods, and services, or any combination of products, goods, and services, provide

• 541-A · reference · effective 2027-01-01

  linical, pricing, financial, reimbursement, data administration or reporting, or billing service; and (d) Such other services as the department may define in rules adopted under RSA 541-A. XII. “Pharmacy benefit manager” means any person that, pursuant to a written agreement with an insurer or health plan, either directly or indirectly, provides one or more pharmacy benefit management services on beh

• 91-A · reference · effective 2027-01-01

  ary nature of the information. Any such information shall be protected from disclosure as confidential and proprietary information, shall not be regarded as a public record under RSA 91-A. A pharmacy benefit manager shall impose the confidentiality protections and requirements of this section on any agent or downstream third party that performs health care or administrative services on behalf of the pha

RSAs mentioned by this document

• RSA 91-A · ACCESS TO GOVERNMENTAL RECORDS AND MEETINGS
• RSA 402-N · PHARMACY BENEFITS MANAGERS
• RSA 420-J · MANAGED CARE LAW
• RSA 541-A · ADMINISTRATIVE PROCEDURE ACT
• RSA 402-N:1 · Definitions
• RSA 402-N:2 · Registration to do Business; Rulemaking; Penalties
• RSA 402-N:3 · Provider Contract Standards for Pharmacy Benefit Managers
• RSA 402-N:4 · Prescription Drugs
• RSA 402-N:9 · Severability
• RSA 420-J:3 · Definitions