SB 251

  • Virginia Senate Bill
  • 2020 Regular Session
  • Introduced in Senate Jan 02, 2020
  • Passed Senate Feb 04, 2020
  • Passed House Feb 21, 2020
  • Signed by Governor May 21, 2020

Pharmacy benefits managers; licensure and regulation definitions.

Abstract

Pharmacy benefits managers; licensure and regulation. Provides that no person is authorized to provide pharmacy benefits management services or otherwise act as a pharmacy benefits manager without first obtaining a license from the State Corporation Commission. The measure prohibits a carrier on its own or through its contracted pharmacy benefits manager or representative of a pharmacy benefits manager from (i) causing or knowingly permitting the use of any advertisement, promotion, solicitation, representation, proposal, or offer that is untrue; (ii) charging a pharmacist or pharmacy a fee related to the adjudication of a claim other than a reasonable fee for an initial claim submission; (iii) reimbursing a pharmacy or pharmacist an amount less than the amount that the pharmacy benefits manager reimburses a pharmacy benefits manager affiliate for providing the same pharmacist services, calculated on a per-unit basis using the same generic product identifier or generic code number and reflecting all drug manufacturer's rebates, direct and indirect administrative fees, and costs and any remuneration; or (iv) penalizing or retaliating against a pharmacist or pharmacy for exercising rights provided by this measure. The measure also prohibits a carrier from (a) imposing provider accreditation standards or certification requirements inconsistent with, more stringent than, or in addition to requirements of the Virginia Board of Pharmacy or other state or federal entity; (b) including any mail order pharmacy or pharmacy benefits manager affiliate in calculating or determining network adequacy; or (c) conducting spread pricing in the Commonwealth. The measure also imposes recordkeeping and reporting requirements. The bill has a delayed effective date of October 1, 2020. This bill incorporates SB 252 and SB 862 and is identical to HB 1290.

Pharmacy benefits managers; licensure and regulation. Provides that no person is authorized to provide pharmacy benefits management services or otherwise act as a pharmacy benefits manager without first obtaining a license from the State Corporation Commission. The measure prohibits a carrier on its own or through its contracted pharmacy benefits manager or representative of a pharmacy benefits manager from (i) causing or knowingly permitting the use of any advertisement, promotion, solicitation, representation, proposal, or offer that is untrue; (ii) charging a pharmacist or pharmacy a fee related to the adjudication of a claim other than a reasonable fee for an initial claim submission; (iii) reimbursing a pharmacy or pharmacist an amount less than the amount that the pharmacy benefits manager reimburses a pharmacy benefits manager affiliate for providing the same pharmacist services, calculated on a per-unit basis using the same generic product identifier or generic code number and reflecting all drug manufacturer's rebates, direct and indirect administrative fees, and costs and any remuneration; or (iv) penalizing or retaliating against a pharmacist or pharmacy for exercising rights provided by this measure. The measure also prohibits a carrier from (a) imposing provider accreditation standards or certification requirements inconsistent with, more stringent than, or in addition to requirements of the Virginia Board of Pharmacy or other state or federal entity; (b) including any mail order pharmacy or pharmacy benefits manager affiliate in calculating or determining network adequacy; or (c) conducting spread pricing in the Commonwealth. The measure also imposes recordkeeping and reporting requirements.

Pharmacy benefits managers; licensure and regulation. Provides that, beginning January 1, 2021, no person is authorizedto provide pharmacy benefits management services or otherwise actas a pharmacy benefits manager without first obtaining a licensefrom the State Corporation Commission. Such licenses are to be renewedannually. The bill also imposes recordkeeping and reporting requirementsand provides that information or data acquired therefrom is consideredproprietary and confidential and is not subject to the Virginia Freedomof Information Act.

Bill Sponsors (4)

Votes


Actions


May 21, 2020

Office of the Governor

Approved by Governor-Chapter 1288 (effective - see bill)

Apr 22, 2020

Office of the Governor

Governor's Action Deadline 11:59 p.m., May 22, 2020

Senate

Communicated to Governor

Senate

Second reconsideration requires unanimous consent

Senate

Reconsideration of Governor's recommendation rejected (35-Y 3-N)

Senate

Senate rejected Governor's recommendation (19-Y 21-N)

Senate

Passed by temporarily

Senate

Reconsideration of Governor's recommendation agreed to (40-Y 0-N)

Senate

Senate rejected Governor's recommendation (19-Y 21-N)

Apr 11, 2020

Senate

Governor's recommendation received by Senate

Mar 12, 2020

Senate

Enrolled Bill Communicated to Governor on March 12, 2020

Office of the Governor

Governor's Action Deadline 11:59 p.m., April 11, 2020

Mar 03, 2020

Senate

Signed by President

Mar 02, 2020

Senate

Enrolled

House

Signed by Speaker

Senate

Impact statement from SCC (SB251ER)

Feb 25, 2020

Senate

House amendments agreed to by Senate (38-Y 2-N)

Feb 21, 2020

House

Committee amendments agreed to

House

VOTE: Block Vote Passage (98-Y 0-N)

House

Passed House with amendments BLOCK VOTE (98-Y 0-N)

House

Engrossed by House as amended

House

Read third time

Feb 20, 2020

House

Read second time

Feb 18, 2020

House

Reported from Labor and Commerce with amendments (20-Y 0-N)

House

Referred to Committee on Labor and Commerce

House

Read first time

House

Placed on Calendar

Feb 04, 2020

Senate

Read third time and passed Senate (33-Y 7-N)

Senate

Impact statement from SCC (SB251S1)

Feb 03, 2020

Senate

Read second time

Senate

Engrossed by Senate - committee substitute SB251S1

Senate

Amendments by Senator Hanger rejected

Senate

Reading of amendments waived

Senate

Committee substitute agreed to 20105876D-S1

Senate

Reading of substitute waived

Jan 31, 2020

Senate

Passed by for the day

Jan 30, 2020

Senate

Passed by for the day

Jan 29, 2020

Senate

Constitutional reading dispensed (40-Y 0-N)

Jan 27, 2020

Senate

Incorporates SB252 (Edwards)

Senate

Committee substitute printed 20105876D-S1

Senate

Incorporates SB862 (Pillion)

Senate

Reported from Commerce and Labor with substitute (9-Y 6-N)

Jan 16, 2020

Senate

Impact statement from SCC (SB251)

Jan 15, 2020

Senate

Assigned C&L sub: Health Insurance

Jan 02, 2020

Senate

Referred to Committee on Commerce and Labor

Senate

Prefiled and ordered printed; offered 01/08/20 20101086D

Bill Text

Bill Text Versions Format
Impact statement from SCC (SB251) HTML
Engrossed by Senate - committee substitute SB251S1 HTML
Bill text as passed Senate and House (SB251ER) HTML
Acts of Assembly Chapter text (CHAP1288) HTML

Related Documents

Document Format
Amendment: SB251ASR HTML
Amendment: SB251AHE HTML
Amendment: SB251AH HTML
Amendment: SB251AG HTML

Sources

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