HF 423 — A bill for an act relating to contract pharmacies and covered entities that participate in the 340B drug program.

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' 1,:;I ZA I .I, NSS .1 i;1 IY13 il!17I1 1l1l!8181 I1 81 ",1I1 68!1 8!IIUI II !1 1U!i House File 423 AN ACT RELATING TO CONTRACT PHARMACIES AND COVERED ENTITIES THAT PARTICIPATE IN THE 340B DRUG PROGRAM.

NEW PARAGRAPH.PARAGRAPH .

34OB340B drug program.

-34OB“340B programprogram” - means the program created pursuant to the Veterans Health Care Act of 1992, Pub.

-Commissioner“Commissioner” - means the commissioner of insurance.

-Contract“Contract pharmacypharmacy” - means a pharmacy that has executed a contract with a covered entity to dispense covered outpatient drugs, purchased by the covered entity through the 340B program, to eligible patients of the covered entity.

-Covered“Covered entityentity” - means the same as defined in 42 U.S.C.

S256b(a)(4).§256b(a)(4).

'Group“Group health planplan” - means the same as defined in section 513B.2.

Medicaid“Medicaid managed care organizationorganization” - means an entity acting pursuant to a contract with the department of health and human services to administer the medical assistance program under chapter 249A, and that meets the definition of health“health maintenance organizationorganization” - under section 514B.1.

Pharmacy“Pharmacy benefits managermanager” - means the same as defined in section 510B.1.

Similarly“Similarly situated entity or pharmacypharmacy” - means an entity or pharmacy located in Iowa that is of a generally comparable size, and that operates in a market with similar demographic characteristics, including population size, density, distribution, and vital statistics, and reasonably similar economic and geographic conditions.

Third-party“Third-party administratoradministrator” - means the same as defined in section 510.11.

510D.2 340B drug program ——— contract pharmacies and covered entities.

2.

(7) Requirements related to mandatory disclosure either directly or through a third party, except disclosures required by federal law, of prescription orders that are filled with covered outpatient drugs obtained through the 340E340B program.

Paragraph a“a”, -, subparagraphs (1) and (2), shall not be construed to prohibit adjustments for overpayments or other errors associated with an adjudicated claim.

Paragraph a“a”, -, subparagraph (7), shall not be construed to prohibit modifiers or other identifiers on claims to identify whether a drug was purchased through the 340B program or to prevent duplication of rebates.

Impose any restriction or condition on a covered entity that interferes with the covered entity'sentity’s ability to maximize the value of the discounts obtained by the covered entity through the covered entity'sentity’s participation in the 340B drug program.

The commissioner may take any enforcement action under the commissioner'scommissioner’s authority to enforce compliance with this chapter.

A violation of this chapter shall be an unfair or deceptive act or practice in the business of insurance pursuant to section 507B.4, subsection 33. .

•______________________________ ______________________________ PAT GRASSLEGRASSLEY AMY SINCLAIR Speaker of the House President of the Senate I hereby certify that this bill originated in the House and is known as House File 423, Ninetieth General Assembly.

MEGH______________________________ MEGHAN NELSON ChieChief Clerk of the House Approved ,_______________, 2023 KIM'REYNOLDS______________________________ KIM REYNOLDS Governor