HB20-1078
Pharmacy Benefit Management Firm Claims Payments
| Type | Bill |
|---|---|
| Session | 2020 Regular Session |
| Subjects |
Concerning prescription drug claims submitted by a pharmacy, and, in connection therewith, prohibiting retroactive fees.
Bill Summary:
Beginning January 1, 2021, the act:
- Prohibits a pharmacy benefit management firm (PBM) from reimbursing a pharmacy in an amount less than the amount that the PBM reimburses any affiliate for the same pharmacy services;
- Prohibits PBMs from retroactively reducing payment on a clean claim submitted by a pharmacy unless as the result of an audit conducted in accordance with state law; and
- Requires health insurers that contract with PBMs to ensure that the PBMs are complying with this prohibition.
(Note: This summary applies to this bill as enacted.)
Related Documents & Information
| Date | Version | Documents |
|---|---|---|
| 01/30/2020 | PA1 |
| Activity | Vote | Documents |
|---|---|---|
| Refer House Bill 20-1078 to the Committee of the Whole. | The motion passed on a vote of 5-0. | Vote summary |
| Activity | Vote | Documents |
|---|---|---|
| Adopt amendment L.007 (Attachment F). | The motion passed without objection. | Vote summary |
| Adopt amendment L.006 (Attachment B). | The motion passed without objection. | Vote summary |
| Refer House Bill 20-1078, as amended, to the Committee of the Whole. | The motion passed on a vote of 10-0. | Vote summary |
| Date | Calendar | Motion | Vote | Vote Document |
|---|---|---|---|---|
| 03/13/2020 | Senate Amendments | REPASS |
44
AYE
18
NO
3
OTHER
|
Vote record |
| 03/13/2020 | Senate Amendments | CONCUR |
58
AYE
4
NO
3
OTHER
|
Vote record |
| 02/06/2020 | Third Reading | BILL |
49
AYE
12
NO
2
OTHER
|
Vote record |
| Date | Calendar | Motion | Vote | Vote Document |
|---|---|---|---|---|
| 03/12/2020 | Third Reading | BILL |
24
AYE
10
NO
1
OTHER
|
Vote record |
| 03/12/2020 | Third Reading | AMEND (L.010) |
34
AYE
0
NO
1
OTHER
|
Vote record |
| Date | Amendment Number | Committee/ Floor Hearing | Status | Documents |
|---|---|---|---|---|
| 03/12/2020 | L.010 | Third Reading | Passed | |
| 03/09/2020 | L.009 | Second Reading | Passed [**] | |
| 02/05/2020 | L.008 | Second Reading | Passed [**] | |
| 01/29/2020 | L.006 | HOU Health & Insurance | Passed [*] | |
| 01/29/2020 | L.007 | HOU Health & Insurance | Passed [*] |
| Date | Location | Action |
|---|---|---|
| 04/01/2020 | Governor | Governor Signed |
| 03/23/2020 | Governor | Sent to the Governor |
| 03/17/2020 | House | Signed by the Speaker of the House |
| 03/17/2020 | Senate | Signed by the President of the Senate |
| 03/13/2020 | Senate | House Considered Senate Amendments - Result was to Concur - Repass |
| 03/12/2020 | Senate | Senate Third Reading Passed with Amendments - Floor |
| 03/10/2020 | Senate | Senate Third Reading Laid Over Daily - No Amendments |
| 03/09/2020 | Senate | Senate Second Reading Passed with Amendments - Floor |
| 03/04/2020 | Senate | Senate Committee on Health & Human Services Refer Unamended to Senate Committee of the Whole |
| 02/10/2020 | Senate | Introduced In Senate - Assigned to Health & Human Services |
| 02/06/2020 | House | House Third Reading Passed - No Amendments |
| 02/05/2020 | House | House Second Reading Passed with Amendments - Committee, Floor |
| 02/03/2020 | House | House Second Reading Laid Over Daily - No Amendments |
| 01/29/2020 | House | House Committee on Health & Insurance Refer Amended to House Committee of the Whole |
| 01/08/2020 | House | Introduced In House - Assigned to Health & Insurance |
Prime Sponsor
Sponsor
(None)
Co-Sponsor
| Effective Date | Chapter # | Title | Documents |
|---|---|---|---|
| 09/14/2020 | 98 | Pharmacy Benefit Management Firm Claims Payments |