A bill for an act relating to contract pharmacies and covered entities that participate in the 340B drug program.(See HF 423.)
Impact
The implications of HSB137 are significant for the operations of health plans and pharmacies involved in providing medications under the 340B program. By instituting these protections, the bill aims to create a level playing field for covered entities and ensure that they are not disadvantaged in terms of reimbursement compared to their non-covered counterparts. This change is seen as crucial for maintaining the integrity of the 340B program, which is designed to allow covered entities to provide more affordable care to disadvantaged populations. The enforcement mechanisms outlined in the bill empower the commissioner of insurance to act against any violations, underscoring the seriousness of compliance.
Summary
House Study Bill 137 addresses issues related to contract pharmacies and covered entities participating in the 340B drug program. This legislation aims to establish protections against discrimination by group health plans, health carriers, and pharmacy benefits managers (PBMs) against covered entities and contract pharmacies. It prevents these entities from reimbursing covered pharmacies for prescription drugs and dispensing fees at amounts lower than what is offered to similar entities that do not participate in the 340B program. The bill defines critical terms such as 'covered entity' and 'contract pharmacy', ensuring clarity in enforcement and compliance procedures.
Contention
Notable points of contention surrounding HSB137 stem from concerns about regulatory overreach and the complexities of integrating these changes into existing healthcare frameworks. Opponents may argue that while the intent is to enhance equity in healthcare delivery, such regulations could complicate administrative procedures for health plans and increase operational costs. The bill also stipulates that it does not apply to operations under contracts with the state Medicaid agency or Medicaid managed care organizations, which could be a point of discussion about the breadth of its applicability and potential loopholes.
Replaced by
A bill for an act relating to contract pharmacies and covered entities that participate in the 340B drug program. (Formerly HSB 137.) Effective date: 07/01/2023.
Pharmacies; prohibit drug manufacturer and wholesalers from preventing a licensed pharmacy from acquiring drugs from entities that participate in a particular federal drug discount program
Health: pharmaceuticals; drug manufacturers from engaging in certain conduct with pharmacies participating with a 340B program; prohibit. Amends 1978 PA 368 (MCL 333.1101 - 333.25211) by adding sec. 17757c. TIE BAR WITH: SB 95'25