Delaware 151st General Assembly (2021-2022) Status: Passed House Bipartisan · 8 D · 5 R cosponsors

HB 219 — AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO PHARMACY BENEFITS MANAGERS.

Last action — Enact w/o Sign by Governor

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 151st General Assembly (2021-2022). It reached “Passed House” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there are no live odds of enactment. It would have to be reintroduced in the current session to move again.

Summary

Over 80% of pharmaceuticals in the United States are purchased through pharmacy benefits manager ("PBM") networks. PBMs serve as intermediaries between health plans, pharmaceutical manufacturers, and pharmacies or pharmacists, and PBMs establish networks for patients to receive reimbursement for drugs. Given the scope of PBMs in the healthcare delivery system, this Act is designed to provide enhanced oversight and transparency as it relates to PBMs. Specifically, this Act does the following: (1) If a PBM denies an appeal for reimbursement subject to maximum allowable cost pricing, requires the PBM to provide the national drug code number of wholesalers in Delaware that have the drug in stock below maximum allowable cost. (2) Authorizes a pharmacy or pharmacist to decline to dispense a prescription drug or provide a pharmacy service to a patient if the amount reimbursed by a PBM is less than the pharmacy acquisition cost. If a pharmacy or pharmacist declines to provide a drug or service, the pharmacy or pharmacist must inform the patient that the pharmacy or pharmacist did this because of the costs of providing the drug or service and provide the patient with a list of pharmacies in the area that may provide the drug or service. (3) Requires PBMs to provide a reasonably adequate and accessible pharmacy benefits manager network. (4) Increases transparency by requiring PBMs to provide reports to the Insurance Commissioner on network adequacy and the amount of rebates received by PBMs to provide reports to the Insurance Commissioner on network adequacy and the amount of rebates received by PBMs and distributed to insurers or patients. (5) Prohibits PBMs from engaging in certain conduct, such as spread pricing, false advertising, and reimbursing a pharmacist or pharmacy in an amount less than the PBM reimburses itself or an affiliate for the same drug or service. If a PBM engages in prohibited conduct, the Insurance Commissioner is authorized to deny, suspend, or revoke the PBM's registration under § 3355A of Title 18 or impose penalties or take other enforcement action under § 3359A of Title 18. (6) Clarifies that the Insurance Commissioner is authorized to deny an application for registration filed by a PBM. (7) Increases the registration and renewal fee to be paid by a PBM to better reflect the cost of the registration and renewal process and better align with the fee assessed by other states that require PBMs to register. (8) Transfers § 3359A of Title 18 (regarding penalties and enforcement) to a separate subchapter focused on prohibited practices, penalties, and enforcement. In addition, this Act makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual. Finally, this Act requires a greater than majority vote for passage because § 10 of Article VIII of the Delaware Constitution requires the affirmative vote of three-fifths of the members elected to each house of the General Assembly to increase the effective rate of any tax levied or license fee imposed.

Bill Text

Action History

  1. Enact w/o Sign by Governor

  2. Passed By Senate. Votes: 21 YES

  3. Reported Out of Committee (Banking, Business & Insurance) in Senate with 2 Favorable, 4 On Its Merits

  4. Assigned to Banking, Business & Insurance Committee in Senate

  5. Passed By House. Votes: 41 YES

  6. Reported Out of Committee (Economic Development/Banking/Insurance & Commerce) in House with 3 Favorable, 8 On Its Merits

  7. Introduced and Assigned to Economic Development/Banking/Insurance & Commerce Committee in House

Sponsors

Sponsorship breakdown

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4 sponsors · 14 co-sponsors · 44 not signed on

Sponsors (4)

Co-sponsors (14)

Not signed on (44)

44 members have not signed on to this bill.

Show all 44 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

3/5

Passed 21 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 5000
Democratic 11000
Republican 5000
Total 21000
% of votes cast 100%0%0%0%
How each member voted (21)
Member Party Vote
Bruce C. Ennis — Yea
Colin Bonini — Yea
Ernesto B Lopez — Yea
Kyle Evans Gay — Yea
Sarah McBride — Yea
Bryan Townsend Democratic Yea
Darius J. Brown Democratic Yea
David P. Sokola Democratic Yea
John "Jack" Walsh Democratic Yea
Laura V. Sturgeon Democratic Yea
Marie Pinkney Democratic Yea
Nicole Poore Democratic Yea
S. Elizabeth Lockman Democratic Yea
Spiros Mantzavinos Democratic Yea
Stephanie L. Hansen Democratic Yea
Trey Paradee Democratic Yea
Brian Pettyjohn Republican Yea
Bryant L. Richardson Republican Yea
Dave G. Lawson Republican Yea
David L. Wilson Republican Yea
Gerald W. Hocker Republican Yea

Official roll call →

3/5

Passed 41 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 13000
Democratic 16000
Republican 12000
Total 41000
% of votes cast 100%0%0%0%
How each member voted (41)
Member Party Vote
Andria L. Bennett — Yea
David Bentz — Yea
Gerald L. Brady — Yea
John A. Kowalko — Yea
John L. Mitchell — Yea
Michael Ramone — Yea
Paul S. Baumbach — Yea
Peter C. Schwartzkopf — Yea
Ruth Briggs King — Yea
Sean Matthews — Yea
Sherry Dorsey Walker — Yea
Stephen Smyk — Yea
Valerie Longhurst — Yea
Debra Heffernan Democratic Yea
Edward S. Osienski Democratic Yea
Eric Morrison Democratic Yea
Franklin D. Cooke Democratic Yea
Kendra Johnson Democratic Yea
Kimberly Williams Democratic Yea
Krista Griffith Democratic Yea
Larry Lambert Democratic Yea
Madinah Wilson-Anton Democratic Yea
Melissa Minor-Brown Democratic Yea
Nnamdi O. Chukwuocha Democratic Yea
Sean M. Lynn Democratic Yea
Sherae'a Moore Democratic Yea
Stephanie T. Bolden Democratic Yea
William Bush Democratic Yea
William J. Carson Democratic Yea
Bryan W. Shupe Republican Yea
Charles S Postles Jr. Republican Yea
Daniel B. Short Republican Yea
Jeffrey N. Spiegelman Republican Yea
Jesse R. Vanderwende Republican Yea
Kevin S Hensley Republican Yea
Lyndon D. Yearick Republican Yea
Michael F. Smith Republican Yea
Richard G. Collins Republican Yea
Ronald E. Gray Republican Yea
Shannon Morris Republican Yea
Timothy D. Dukes Republican Yea

Official roll call →

Subjects

taxation healthcare health-insurance
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Frequently asked questions

What does HB 219 do?
Over 80% of pharmaceuticals in the United States are purchased through pharmacy benefits manager ("PBM") networks. PBMs serve as intermediaries between health plans, pharmaceutical manufacturers, and pharmacies or pharmacists, and PBMs establish networks for patients to receive reimbursement for drugs. Given the scope of PBMs in the healthcare delivery system, this Act is designed to provide enhanced oversight and transparency as it relates to PBMs. Specifically, this Act does the following: (1) If a PBM denies an appeal for reimbursement subject to maximum allowable cost pricing, requires the PBM to provide the national drug code number of wholesalers in Delaware that have the drug in stock below maximum allowable cost. (2) Authorizes a pharmacy or pharmacist to decline to dispense a prescription drug or provide a pharmacy service to a patient if the amount reimbursed by a PBM is less than the pharmacy acquisition cost. If a pharmacy or pharmacist declines to provide a drug or service, the pharmacy or pharmacist must inform the patient that the pharmacy or pharmacist did this because of the costs of providing the drug or service and provide the patient with a list of pharmacies in the area that may provide the drug or service. (3) Requires PBMs to provide a reasonably adequate and accessible pharmacy benefits manager network. (4) Increases transparency by requiring PBMs to provide reports to the Insurance Commissioner on network adequacy and the amount of rebates received by PBMs to provide reports to the Insurance Commissioner on network adequacy and the amount of rebates received by PBMs and distributed to insurers or patients. (5) Prohibits PBMs from engaging in certain conduct, such as spread pricing, false advertising, and reimbursing a pharmacist or pharmacy in an amount less than the PBM reimburses itself or an affiliate for the same drug or service. If a PBM engages in prohibited conduct, the Insurance Commissioner is authorized to deny, suspend, or revoke the PBM's registration under § 3355A of Title 18 or impose penalties or take other enforcement action under § 3359A of Title 18. (6) Clarifies that the Insurance Commissioner is authorized to deny an application for registration filed by a PBM. (7) Increases the registration and renewal fee to be paid by a PBM to better reflect the cost of the registration and renewal process and better align with the fee assessed by other states that require PBMs to register. (8) Transfers § 3359A of Title 18 (regarding penalties and enforcement) to a separate subchapter focused on prohibited practices, penalties, and enforcement. In addition, this Act makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual. Finally, this Act requires a greater than majority vote for passage because § 10 of Article VIII of the Delaware Constitution requires the affirmative vote of three-fifths of the members elected to each house of the General Assembly to increase the effective rate of any tax levied or license fee imposed.
Who sponsors HB 219?
HB 219 is sponsored by Kyle Evans Gay, Spiros Mantzavinos (Democratic), David P. Sokola (Democratic), Michael F. Smith (Republican), Stephanie L. Hansen (Democratic), Gerald W. Hocker (Republican), Dave G. Lawson (Republican), Brian Pettyjohn (Republican), Nicole Poore (Democratic), John "Jack" Walsh (Democratic), David L. Wilson (Republican), Edward S. Osienski (Democratic), Kimberly Williams (Democratic), William Bush (Democratic), Ruth Briggs King, Paul S. Baumbach, Ernesto B Lopez, and Andria L. Bennett.
What is the current status of HB 219?
This bill died with 151st General Assembly (2021-2022). It reached “Passed House” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track HB 219?
Track HB 219 free on One Click Politics — get push/email alerts when it moves.

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