Idaho 67th Legislature, 2nd Regular Session (2024) Status: Enacted

H 596 — PHARMACY BENEFIT MANAGERS – Amends existing law to establish provisions governing pharmacy benefit managers.

Last action — Reported Signed by Governor on April 1, 2024 Session Law Chapter 247 Effective: 01/01/2025

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

This bill has been enacted into law. Introduced February 19, 2024. Enacted.

Signed by Governor Brad Little (Republican) on April 02, 2024.

Prognosis

Advancing 50% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

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Bill Text

What changed in the latest version

152 added · 125 removed

152 line(s) added, 125 removed.

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596 BY HEALTH AND WELFARE COMMITTEE AN ACT RELATING TO PHARMACY BENEFIT MANAGERS;
596, As Amended in the Senate BY HEALTH AND WELFARE COMMITTEE AN ACT RELATING TO PHARMACY BENEFIT MANAGERS;
AND DECLARING AN EMERGENCY AND PROVIDING AN EFFECTIVE DATE.
AND PROVIDING AN EFFECTIVE DATE.
(h) At a minimum, require the pharmacy benefit manager or pharmacy ben- efits plan or program to, upon revising its formulary of covered pre - scription drugs during a plan year, provide a sixty (60) day continu - ity-of-care period in which the covered prescription drug that is being revised from the formulary continues to be provided at the same cost for the patient for a period of sixty (60) days.
(h) At a minimum, require the pharmacy benefit manager or pharmacy ben- efits plan or program to, upon revising its formulary of covered pre - scription drugs during a plan year, provide a ninety (90) day continu - ity-of-care period in which the covered prescription drug that is being revised from the formulary continues to be provided at the same cost for the patient for a period of ninety (90) days.
The sixty (60) day conti - nuity-of-care period commences upon notification to the patient.
The ninety (90) day conti - nuity-of-care period commences upon notification to the patient.
or (iii) Is subject to an involuntary recall by state or federal au- thorities and is no longer available on the commercial market;
(iii) Is subject to an involuntary recall by state or federal au- thorities and is no longer available on the commercial market;
(i) Require that in-network pharmacies receive dispensing fees that are not less than the Idaho medicaid fee for service dispensing fees in effect on the date of service;
or (iv) Has a generic, biosimilar, or interchangeable biologic ap- proved by the United States food and drug administration;
(i) Require that in-network pharmacies receive dispensing fees that reasonably cover the costs of dispensing medications;
(12) In addition to other requirements in this title, a participation contract executed, amended, adjusted, or renewed between a pharmacy benefit manager and one (1) or more pharmacies or pharmacists must include, in sub - stantial form, to the extent allowable by law, terms that ensure compliance with the provisions of this subsection.
(12) The requirements of subsection (11) of this section shall not ap- ply to specialty drugs.
For the purposes of this section, "specialty drug" means:
(a) A drug that is subject to restricted distribution by the United States food and drug administration;
or (b) A drug that requires special handling, provider coordination, or patient education that a retail pharmacy cannot provide.
(13) In addition to other requirements in this title, a participation contract executed, amended, adjusted, or renewed between a pharmacy benefit manager and one (1) or more pharmacies or pharmacists must include, in sub- stantial form, to the extent allowable by law, terms that ensure compliance with the provisions of this subsection.
(13) In addition to other prohibitions in this section, a pharmacy bene- fit manager may not do any of the following:
(14) In addition to other prohibitions in this section, a pharmacy bene- fit manager may not do any of the following:
(e) Fail to make any payment due to a pharmacy for an adjudicated claim with a date of service before the effective date of a pharmacy's ter - mination from a pharmacy benefit network, unless payments are withheld because of fraud on the part of the pharmacy or except as otherwise re - quired by law;
(e) Fail to make any payment due to a pharmacy for an adjudicated claim with a date of service before the effective date of a pharmacy's ter - mination from a pharmacy benefit network, unless payments are withheld because of fraud, waste, or abuse on the part of the pharmacy or except as otherwise required by law;
or (f) Terminate the contract of, penalize, or disadvantage a pharmacist or pharmacy due to a pharmacist or pharmacy:
or (f) Terminate the contract of, penalize, or disadvantage a pharmacist or pharmacy solely due to a pharmacist or pharmacy:
(15) In complying with the requirements of this section, a pharmacy benefit manager or its agents, and the director or the director's agents, shall not directly or indirectly publish or otherwise disclose any infor - mation reported to the director under this section that would reveal:
the identity of a specific pharmacy benefits plan, program, or pharmaceutical manufacturer;
the prices charged for a specific drug or class of drugs;
the amount of any rebates provided for a specific drug or class of drugs or the pharmaceutical manufacturer;
or information that would otherwise have the potential to compromise the financial, competitive, or proprietary nature of such information.
Any such information shall be protected from disclo - sure as confidential and proprietary and shall not be regarded as a public record pursuant to section 74-101, Idaho Code.
A pharmacy benefit manager shall impose the confidentiality protections and requirements of this sec - tion on any agent or downstream third party that performs health care or administrative services on behalf of the pharmacy benefit manager that may receive or have access to such information, and the director shall impose the confidentiality protections and requirements of this section on any agent or downstream third party directly or indirectly involved in the administra - tion of this section that may receive or have access to such information.
An emergency existing therefor, which emergency is hereby declared to exist, this act shall be in full force and effect on and after July 1, 2024.
This act shall be in full force and effect on and after Jan- uary 1, 2025.
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Amendments

1 amendment

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Action History

  1. Reported Signed by Governor on April 1, 2024 Session Law Chapter 247 Effective: 01/01/2025

  2. Delivered to Governor at 4:15 p.m. on March 26, 2024

  3. Returned Signed by the President; Ordered Transmitted to Governor

  4. Signed by President; returned to House

  5. Received from the House enrolled/signed by Speaker

  6. Reported Enrolled; Signed by Speaker; Transmitted to Senate

  7. Read third time in full as amended in Senate – PASSED - 53-15-2AYES – Achilles, Allgood, Andrus, Blanksma, Boyle, Bundy, Cannon, Cheatum, Chew(Harada), Clow, Cornilles, Crane(12), Crane(13), Dixon(1), Dixon(24), Durrant, Ehardt, Erickson, Furniss, Galaviz, Gannon, Garner, Handy, Healey, Hill, Holtzclaw(Johnson), Kingsley, Lanting, Manwaring, McCann, Mickelsen, Miller, Mitchell, Monks, Necochea, Nelsen, Palmer, Petzke, Pickett, Raybould, Raymond, Redman, Roberts, Rubel, Sauter, Shepherd, Vander Woude, Weber(Weber), Wheeler, Wroten, Yamamoto, Young, Mr. SpeakerNAYS – Alfieri, Barbieri, Berch, Ehlers, Gallagher, Green, Hawkins, Lambert, Mathias, Mendive, Price, Scott, Skaug, Tanner, WisniewskiAbsent – Burns, HormanFloor Sponsor - RedmanTitle apvd - to enrol

  8. Read second time as amended in Senate; Filed for Third Reading

  9. Read first time as amended in Senate; Filed for Second Reading

  10. Reported Engrossed; Filed for First Reading of Engrossed Bills

  11. Bills as Amended Referred to JRA for Engrossing

  12. House Concurred in Senate Amendments

  13. Reported out of Committee and Recommend Concurrence

  14. Referred to Health & Welfare for concurrence recommendation

  15. Returned from the Senate Amended

  16. Rules Suspended (2/3 Vote - Read in full as required) – PASSED - 27-8-0AYES – Adams, Anthon, Bernt, Bjerke, Burtenshaw, Cook, Den Hartog, Foreman, Grow, Guthrie, Harris, Hartgen, Just, Lakey, Lee, Lent, Rabe, Ricks, Ruchti, Schroeder, Semmelroth, Taylor, Trakel, VanOrden, Ward-Engelking, Winder, WintrowNAYS – Carlson, Hart, Herndon, Lenney, Nichols, Okuniewicz, Toews, ZuiderveldAbsent and excused – NoneFloor Sponsor - CookTitle apvd - to House

  17. Read first time as amended in the Senate; Filed for Second Reading

  18. Amendments reported printed

  19. Reported out as amended; filed for first reading

  20. Amendments ordered printed

  21. Placed in the Committee of the Whole

  22. Reported out of committee; to 14th Order for amendment

  23. Introduced, read first time; referred to: Health & Welfare

  24. Received from the House passed; filed for first reading

  25. Read Third Time in Full – PASSED - 41-29-0AYES – Achilles, Allgood, Andrus, Berch, Boyle, Cannon, Cheatum, Chew(Schmick), Clow, Crane(12), Crane(13), Dixon(1), Durrant, Ehardt, Erickson, Furniss, Handy, Healey, Hill, Holtzclaw, Horman, Kingsley, Manwaring, Mathias(Church), Miller, Mitchell, Monks, Necochea, Palmer(Johnson), Pickett, Raymond, Redman, Roberts, Rubel, Sauter, Shepherd, Vander Woude, Weber, Wroten, Young, Mr. SpeakerNAYS – Alfieri, Barbieri, Blanksma, Bundy, Burns, Cornilles, Dixon(24), Ehlers, Galaviz, Gallagher, Gannon, Garner, Green, Hawkins, Lambert, Lanting, McCann, Mendive, Mickelsen, Nelsen, Petzke, Price, Raybould, Scott, Skaug, Tanner, Wheeler, Wisniewski, YamamotoAbsent – NoneFloor Sponsor - RedmanTitle apvd - to Senate

  26. U.C. to hold place on third reading calendar one legislative day

  27. U.C. to place at bottom of House bills of third reading calendar one legislative day

  28. U.C. to hold place on third reading calendar until Monday, March 4, 2024

  29. Read second time; Filed for Third Reading

  30. Reported out of Committee with Do Pass Recommendation, Filed for Second Reading

  31. Reported Printed and Referred to Health & Welfare

  32. Introduced, read first time, referred to JRA for Printing

Sponsors

  • HEALTH AND WELFARE COMMITTEE · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 104 not signed on

Sponsors (1)

  • HEALTH AND WELFARE COMMITTEE

Co-sponsors (0)

None.

Not signed on (104)

104 members have not signed on to this bill.

Show all 104 →

"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

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors H 596?
H 596 is sponsored by HEALTH AND WELFARE COMMITTEE.
What is the current status of H 596?
This bill has been enacted into law. Introduced February 19, 2024. Enacted.
Where can I track H 596?
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