SB 1340 creates a new section of Missouri law governing how health carriers and pharmacy benefits managers (PBMs) may reimburse and interact with “covered entities” that participate in the federal 340B drug-pricing program. The bill defines key terms such as 340B drugs, covered entities, health carriers, pharmacies, and PBMs, and then prohibits discrimination against covered entities because they dispense 340B drugs or participate in the 340B program.
The bill bars carriers, PBMs, and their agents or affiliates from reimbursing covered entities less than similarly situated non-covered pharmacies for the same 340B drug, from imposing different fees, audits, network restrictions, inventory requirements, or other conditions, and from requiring covered entities to identify 340B drugs or reverse or resubmit claims except in limited circumstances. It also prohibits refusing to cover drugs purchased under 340B and authorizes the Department of Commerce and Insurance to adopt rules and enforce the section.
Impact
SB 1340 would add section 376.417 to Missouri’s insurance and pharmacy-benefit statutes, expanding state regulation of PBM and health carrier reimbursement practices as they relate to the federal 340B program. It would give the Department of Commerce and Insurance enforcement authority, including civil penalties of up to $5,000 per violation per day, and require rulemaking to define terms such as “similarly situated” pharmacies and to implement the anti-discrimination standards. The bill would primarily affect health carriers, PBMs, pharmacies, hospitals, clinics, and other 340B covered entities that dispense discounted drugs through the federal program.
Sentiment
Based on the bill text and the absence of recorded committee debate or votes in the provided materials, the measure appears to be framed as a protective, pro-provider bill aimed at preserving the value of 340B discounts for covered entities. The overall policy direction suggests support for hospitals and safety-net providers that rely on 340B savings, while placing new compliance obligations on insurers and PBMs. No formal vote history or transcript is available here to show organized opposition or amendment activity.
Contention
The likely points of contention are the bill’s restrictions on PBM and insurer contracting and reimbursement practices, especially the ban on lower reimbursement, special audit or network conditions, and claim reprocessing requirements tied to 340B status. Opponents would likely argue that the bill limits PBM and carrier flexibility, could increase administrative costs, and may complicate fraud-prevention or claims-processing practices. Supporters would likely emphasize that the bill prevents discriminatory treatment of 340B providers and protects access to discounted prescription drugs for safety-net patients.