S 342 — Pharmacy services

2025-2026 Bill 342 Text of Previous Version (Mar.(Feb.

12,13, 2026)2025) - South Carolina Legislature Online South Carolina General Assembly126th Session, 2025-2026Bill 342Indicates Matter StrickenIndicates New Matter(Text matches printed bills.

Document has been reformatted to meet World Wide Web specifications.) Indicates  Matter  Stricken  Indicates  New  Matter    Committee  ReportA Marchbill 12,  2026TO  AMEND S.THE SOUTH CAROLINA CODE OF LAWS BY AMENDING SECTION 38-71-2200, RELATING TO DEFINITIONS, SO AS TO DEFINE "LOW-VOLUME PHARMACY";

342   Introduced by Senators Rankin, Peeler, Goldfinch, Gambrell, Blackmon, Graham, Turner and Young   S.

Printed 3/12/26--S.

Read the first time February 13, 2025   ________   The committee on Senate Banking and Insurance To whom was referred a Bill (S.

342) to amend the South Carolina Code of Laws by amending Section 38-71-2200, relating to definitions, so as to define "low-volume pharmacy";

by adding Section 38-71-2270, etc., respectfully Report:

That they have duly and carefully considered the same, and recommend that the same do pass with amendment:

     Amend the bill, as and if amended, by deleting SECTION 1 from the bill.

Amend the bill further, SECTION 2, by striking Section 38-71-2270(C), (D), (E), (F), (G), (H) and (I) and inserting:

    (C) The professional dispensing fee described in this section is subject to annual review and adjustment by the South Carolina Department of Insurance, provided that any adjustment must not result in a dispensing fee less than the average cost to dispense a prescription drug in an ambulatory pharmacy setting in South Carolina.A pharmacy or pharmacist that has been reimbursed below the minimum amount that is required by this section may file a complaint with the Department of Insurance using a standard form that the Department must post online.

Upon receipt of a complete complaint form, the Department must provide the information in the form to the PBM and permit it ten business days to respond.  The Department must make a determination regarding the complaint within thirty days of receiving a response from the PBM.

If the complaint is upheld, the Department must notify the pharmacy or pharmacist and the PBM, which must:

       (1) pay the pharmacy or pharmacist within thirty days twice the amount of the insufficiency of the original payment;

and        (2) make the change effective for each similarly situated pharmacy and reimburse each pharmacy the amount of underpayment.

    (D) A PBM may not reimburse a pharmacy or pharmacist for a prescription drug or pharmacy service in an amount less than the amount the PBM reimburses itself or an affiliate for the same prescription drug or pharmacy service.

For the purposes of this section, an "affiliate" means any pharmacy, pharmacist, or pharmacy technician that shares common ownership with the PBM or is otherwise associated with the PBM.The Department of Insurance may promulgate regulations necessary to implement the provisions of this act.

    (E) Low-volume pharmacies are entitled to an enhanced professional dispensing fee.

The fee shall be no less than the dispensing fee established for low-volume pharmacies by South Carolina Medicaid's fee for service pharmacy benefit program.

    (F) When a pharmacy dispenses a specialized delivery drug, it is entitled to a dispensing fee equal to twice the professional dispensing fee provided in this section.

    (G) A pharmacy or pharmacist that has been reimbursed below the minimum amount that is required by this section may file a complaint with the Department of Insurance using a standard form that the department must post online.

Upon receipt of a complete complaint form, the department must provide the information in the form to the PBM and permit it ten business days to respond.

The department must make a determination regarding the complaint within thirty days of receiving a response from the PBM.

If the complaint is upheld, the department must notify the pharmacy or pharmacist and the PBM, which must:

       (1) pay the pharmacy or pharmacist within thirty days twice the amount of the insufficiency of the original payment;

       (2) make the change effective for each similarly situated pharmacy and reimburse each pharmacy the amount of underpayment.

    (H) The Department of Insurance may promulgate regulations necessary to implement the provisions of this act, including the establishment of a certification process for low-volume pharmacies.

    (I) The provisions of this section do not apply to the coverage provided to employees, retirees, and their eligible dependents pursuant to Section 1-11-710 by the South Carolina Public Employee Benefit Authority or through its contracted pharmacy benefits manager.The provisions of this section do not apply to the coverage provided to employees, retirees, and their eligible dependents pursuant to Section 1-11-710 by the South Carolina Public Employee Benefit Authority or through its contracted pharmacy benefits manager.

Amend the bill further, by adding an appropriately numbered SECTION to read:

SECTION X.

Section 38-2-10(A)(1) of the S.C.

Code is amended to read:

         (1) If the violator is an insurer, pharmacy benefits manager, or a health maintenance organization licensed in this State, the director or his designee shall fine the violator in an amount not to exceed fifteen thousand dollars, suspend or revoke the violator's authority to do business in this State, or both.

If the violator is a pharmacy benefits manager, the director or his designee shall fine the pharmacy benefits manager in an amount not less than ten thousand dollars per violation.

If the violation is wilful, the director or his designee shall fine the violator in an amount not to exceed thirty thousand dollars, suspend or revoke the violator's authority to do business in this State, or both.

However, if a pharmacy benefits manager commits a wilful violation, the director or his designee shall fine the pharmacy benefits manager in an amount not less than one hundred thousand dollars and not more than one million dollars in addition to suspending or revoking the pharmacy benefits manager's authority to do business in this State.

Amend the bill further, SECTION 3, by striking Section 38-71-2230(A)(6) and inserting:

       (6) Reserved;reimburse a pharmacy or pharmacist for a prescription drug or pharmacy service in an amount less than the amount the PBM reimburses itself or an affiliate for the same prescription drug or pharmacy service.

For the purposes of this section, an "affiliate" means any pharmacy, pharmacist, or pharmacy technician that shares common ownership with the PBM or is otherwise associated with the PBM;