House
File
2384
-
Enrolled
House
File
2384
AN
ACT
RELATING
TO
PHARMACY
BENEFITS
MANAGERS,
PHARMACIES,
AND
PRESCRIPTION
DRUG
BENEFITS,
AND
INCLUDING
EFFECTIVE
DATE
AND
APPLICABILITY
PROVISIONS.
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
DIVISION
I
PHARMACY
BENEFITS
MANAGERS,
PHARMACIES,
AND
PRESCRIPTION
DRUG
BENEFITS
Section
1.
Section
507B.4,
subsection
3,
Code
2022,
is
amended
by
adding
the
following
new
paragraph:
NEW
PARAGRAPH
.
t.
Pharmacy
benefits
managers.
Any
violation
of
chapter
510B
by
a
pharmacy
benefits
manager.
Sec.
2.
Section
510B.1,
Code
2022,
is
amended
by
striking
the
section
and
inserting
in
lieu
thereof
the
following:
510B.1
Definitions.
As
used
in
this
chapter,
unless
the
context
otherwise
requires:
1.
“Clean
claim”
means
a
claim
that
has
no
defect
or
impropriety,
including
a
lack
of
any
required
substantiating
documentation,
or
other
circumstances
requiring
special
treatment,
that
prevents
timely
payment
from
being
made
on
the
claim.
House
File
2384,
p.
2
2.
“Commissioner
”
means
the
commissioner
of
insurance.
3.
“Cost-sharing”
means
any
coverage
limit,
copayment,
coinsurance,
deductible,
or
other
out-of-pocket
cost
obligation
imposed
by
a
health
benefit
plan
on
a
covered
person.
4.
“Covered
person”
means
a
policyholder,
subscriber,
or
other
person
participating
in
a
health
benefit
plan
that
has
a
prescription
drug
benefit
managed
by
a
pharmacy
benefits
manager.
5.
“Facility”
means
an
institution
providing
health
care
services
or
a
health
care
setting,
including
but
not
limited
to
hospitals
and
other
licensed
inpatient
centers,
ambulatory
surgical
or
treatment
centers,
skilled
nursing
centers,
residential
treatment
centers,
diagnostic,
laboratory
and
imaging
centers,
and
rehabilitation
and
other
therapeutic
health
settings.
6.
“Health
benefit
plan”
means
a
policy,
contract,
certificate,
or
agreement
offered
or
issued
by
a
third-party
payor
to
provide,
deliver,
arrange
for,
pay
for,
or
reimburse
any
of
the
costs
of
health
care
services.
7.
“Health
care
professional”
means
a
physician
or
other
health
care
practitioner
licensed,
accredited,
registered,
or
certified
to
perform
specified
health
care
services
consistent
with
state
law.
8.
“Health
care
provider”
means
a
health
care
professional
or
a
facility.
9.
“Health
carrier”
means
an
entity
subject
to
the
insurance
laws
and
regulations
of
this
state,
or
subject
to
the
jurisdiction
of
the
commissioner,
including
an
insurance
company
offering
sickness
and
accident
plans,
a
health
maintenance
organization,
a
nonprofit
health
service
corporation,
or
a
plan
established
pursuant
to
chapter
509A
for
public
employees.
“Health
carrier”
does
not
include
any
of
the
following:
a.
The
department
of
human
services.
b.
A
managed
care
organization
acting
pursuant
to
a
contract
with
the
department
of
human
services
to
administer
the
medical
assistance
program
under
chapter
249A
or
the
healthy
and
well
kids
in
Iowa
(hawk-i)
program
under
chapter
514I.
c.
A
policy
or
contract
providing
a
prescription
drug
House
File
2384,
p.
3
benefit
pursuant
to
42
U.S.C.
ch.
7,
subch.
XVIII,
part
D.
d.
A
plan
offered
or
maintained
by
a
multiple
employer
welfare
arrangement
established
under
chapter
513D
before
January
1,
2022.
10.
“Maximum
allowable
cost”
means
the
maximum
amount
that
a
pharmacy
will
be
reimbursed
by
a
pharmacy
benefits
manager
or
a
health
carrier
for
a
generic
drug,
brand-name
drug,
biologic
product,
or
other
prescription
drug,
and
that
may
include
any
of
the
following:
a.
Average
acquisition
cost.
b.
National
average
acquisition
cost.
c.
Average
manufacturer
price.
d.
Average
wholesale
price.
e.
Brand
effective
rate.
f.
Generic
effective
rate.
g.
Discount
indexing.
h.
Federal
upper
limits.
i.
Wholesale
acquisition
cost.
j.
Any
other
term
used
by
a
pharmacy
benefits
manager
or
a
health
carrier
to
establish
reimbursement
rates
for
a
pharmacy.
11.
“Maximum
allowable
cost
list”
means
a
list
of
prescription
drugs
that
includes
the
maximum
allowable
cost
for
each
prescription
drug
and
that
is
used,
directly
or
indirectly,
by
a
pharmacy
benefits
manager.
12.
“Pharmacist”
means
the
same
as
defined
in
section
155A.3.
13.
“Pharmacy”
means
the
same
as
defined
in
section
155A.3.
14.
“Pharmacy
acquisition
cost”
means
the
cost
to
a
pharmacy
for
a
prescription
drug
as
invoiced
by
a
wholesale
distributor,
and
reduced
by
any
discounts,
rebates,
or
other
price
concessions
applicable
to
the
prescription
drug
that
are
not
shown
on
the
invoice
and
are
known
at
the
time
that
the
pharmacy
files
an
appeal
with
a
pharmacy
benefits
manager.
15.
“Pharmacy
benefits
manager”
means
a
person
who,
pursuant
to
a
contract
or
other
relationship
with
a
third-party
payor,
either
directly
or
through
an
intermediary,
manages
a
prescription
drug
benefit
provided
by
the
third-party
payor.
16.
“Pharmacy
benefits
manager
affiliate”
means
a
pharmacy
or
a
pharmacist
that
directly
or
indirectly
through
one
or
more
House
File
2384,
p.
4
intermediaries,
owns
or
controls,
is
owned
and
controlled
by,
or
is
under
common
ownership
or
control
of,
a
pharmacy
benefits
manager.
17.
“Pharmacy
network”
or
“network”
means
pharmacies
that
have
contracted
with
a
pharmacy
benefits
manager
to
dispense
or
sell
prescription
drugs
to
covered
persons
of
a
health
benefit
plan
for
which
the
pharmacy
benefits
manager
manages
the
prescription
drug
benefit.
18.
“Prescription
drug”
means
the
same
as
defined
in
section
155A.3.
19.
“Prescription
drug
benefit”
means
a
health
benefit
plan
providing
for
third-party
payment
or
prepayment
for
prescription
drugs.
20.
“Prescription
drug
order”
means
the
same
as
defined
in
section
155A.3.
21.
“Rebate”
means
all
discounts
and
other
negotiated
price
concessions
paid
directly
or
indirectly
by
a
pharmaceutical
manufacturer
or
other
entity,
other
than
a
covered
person,
in
the
prescription
drug
supply
chain
to
a
pharmacy
benefits
manager,
and
which
may
be
based
on
any
of
the
following:
a.
A
pharmaceutical
manufacturer’s
list
price
for
a
prescription
drug.
b.
Utilization.
c.
To
maintain
a
net
price
for
a
prescription
drug
for
a
specified
period
of
time
for
the
pharmacy
benefits
manager
in
the
event
the
pharmaceutical
manufacturer’s
list
price
increases.
d.
Reasonable
estimates
of
the
volume
of
a
prescribed
drug
that
will
be
dispensed
by
a
pharmacy
to
covered
persons.
22.
“Third-party
payor”
means
any
entity
other
than
a
covered
person
or
a
health
care
provider
that
is
responsible
for
any
amount
of
reimbursement
for
a
prescription
drug
benefit.
“Third-party
payor”
includes
health
carriers
and
other
entities
that
provide
a
plan
of
health
insurance
or
health
care
benefits.
“Third-party
payor”
does
not
include
any
of
the
following:
a.
The
department
of
human
services.
b.
A
managed
care
organization
acting
pursuant
to
a
contract
with
the
department
of
human
services
to
administer
the
medical
assistance
program
under
chapter
249A
or
the
healthy
and
well
House
File
2384,
p.
5
kids
in
Iowa
(hawk-i)
program
under
chapter
514I.
c.
A
policy
or
contract
providing
a
prescription
drug
benefit
pursuant
to
42
U.S.C.
ch.
7,
subch.
XVIII,
part
D.
23.
“Wholesale
distributor”
means
the
same
as
defined
in
section
155A.3.
Sec.
3.
Section
510B.4,
Code
2022,
is
amended
to
read
as
follows:
510B.4
Performance
of
duties
——
good
faith
——
conflict
of
interest.
1.
A
pharmacy
benefits
manager
shall
perform
the
pharmacy
benefits
manager’s
duties
exercising
exercise
good
faith
and
fair
dealing
in
the
performance
of
its
the
pharmacy
benefits
manager’s
contractual
obligations
toward
the
covered
entity
a
third-party
payor
.
2.
A
pharmacy
benefits
manager
shall
notify
the
covered
entity
a
health
carrier
in
writing
of
any
activity,
policy,
practice
ownership
interest,
or
affiliation
of
the
pharmacy
benefits
manager
that
presents
any
conflict
of
interest.
3.
A
pharmacy
benefits
manager
shall
act
in
the
best
interest
of
each
third-party
payor
for
whom
the
pharmacy
benefits
manager
manages
a
prescription
drug
benefit
provided
by
the
third-party
payor,
and
shall
discharge
its
duties
in
accordance
with
applicable
state
and
federal
law.
Sec.
4.
Section
510B.5,
Code
2022,
is
amended
to
read
as
follows:
510B.5
Contacting
covered
individual
persons
——
requirements.
A
pharmacy
benefits
manager,
unless
authorized
pursuant
to
the
terms
of
its
contract
with
a
covered
entity
health
carrier
,
shall
not
contact
any
covered
individual
person
without
the
express
written
permission
of
the
covered
entity
health
carrier
.
Sec.
5.
Section
510B.6,
Code
2022,
is
amended
to
read
as
follows:
510B.6
Dispensing
of
substitute
Substitute
prescription
drug
for
prescribed
drug
drugs
.
1.
The
following
provisions
shall
apply
when
if
a
pharmacy
benefits
manager
requests
the
dispensing
of
a
substitute
prescription
drug
for
a
prescribed
drug
to
prescribed
for
a
covered
individual
person
:
House
File
2384,
p.
6
a.
The
pharmacy
benefits
manager
may
request
the
substitution
of
a
lower
priced
generic
and
therapeutically
equivalent
prescription
drug
for
a
higher
priced
prescribed
prescription
drug.
b.
If
the
substitute
prescription
drug’s
net
cost
to
the
covered
individual
person
or
covered
entity
to
the
health
carrier
exceeds
the
cost
of
the
prescribed
prescription
drug
originally
prescribed
for
the
covered
person
,
the
substitution
shall
be
made
only
for
medical
reasons
that
benefit
the
covered
individual
person
.
2.
A
pharmacy
benefits
manager
shall
obtain
the
approval
of
the
prescribing
practitioner
health
care
professional
prior
to
requesting
any
substitution
under
this
section
.
3.
A
pharmacy
benefits
manager
shall
not
substitute
an
equivalent
prescription
drug
contrary
to
a
prescription
drug
order
that
prohibits
a
substitution.
Sec.
6.
Section
510B.7,
Code
2022,
is
amended
by
striking
the
section
and
inserting
in
lieu
thereof
the
following:
510B.7
Pharmacy
networks.
A
pharmacy
benefits
manager
shall
not
assess,
charge,
or
collect
any
form
of
remuneration
that
passes
from
a
pharmacy
or
a
pharmacist
in
a
pharmacy
network
to
the
pharmacy
benefits
manager
including
but
not
limited
to
claim
processing
fees,
performance-based
fees,
network
participation
fees,
or
accreditation
fees.
Sec.
7.
Section
510B.8,
Code
2022,
is
amended
by
striking
the
section
and
inserting
in
lieu
thereof
the
following:
510B.8
Prescription
drugs
——
point
of
sale.
1.
A
covered
person
shall
not
be
required
to
make
a
cost-sharing
payment
at
the
point
of
sale
for
a
prescription
drug
in
an
amount
that
exceeds
the
total
amount
that
the
pharmacy
at
which
the
covered
person
fills
the
covered
person’s
prescription
drug
order
is
reimbursed.
2.
A
pharmacy
benefits
manager
shall
not
prohibit
a
pharmacy
from
disclosing
the
availability
of
a
lower-cost
prescription
drug
option
to
a
covered
person,
or
from
selling
a
lower-cost
prescription
drug
option
to
a
covered
person.
Sec.
8.
NEW
SECTION
.
510B.8A
Maximum
allowable
cost
lists.
1.
Prior
to
placement
of
a
particular
prescription
drug
on
a
House
File
2384,
p.
7
maximum
allowable
cost
list,
a
pharmacy
benefits
manager
shall
ensure
that
all
of
the
following
requirements
are
met:
a.
The
particular
prescription
drug
must
be
listed
as
therapeutically
and
pharmaceutically
equivalent
in
the
most
recent
edition
of
the
publication
entitled
“Approved
Drug
Products
with
Therapeutic
Equivalence
Evaluations”,
published
by
the
United
States
food
and
drug
administration,
otherwise
known
as
the
orange
book.
b.
The
particular
prescription
drug
must
not
be
obsolete
or
temporarily
unavailable.
c.
The
particular
prescription
drug
must
be
available
for
purchase,
without
limitations,
by
all
pharmacies
in
the
state
from
a
national
or
regional
wholesale
distributor
that
is
licensed
in
the
state.
2.
For
each
maximum
allowable
cost
list
that
a
pharmacy
benefits
manager
uses
in
the
state,
the
pharmacy
benefits
manager
shall
do
all
of
the
following:
a.
Provide
each
pharmacy
in
a
pharmacy
network
reasonable
access
to
the
maximum
allowable
cost
list
to
which
the
pharmacy
is
subject.
b.
Update
the
maximum
allowable
cost
list
within
seven
calendar
days
from
the
date
of
an
increase
of
ten
percent
or
more
in
the
pharmacy
acquisition
cost
of
a
prescription
drug
on
the
list
by
one
or
more
wholesale
distributors
doing
business
in
the
state.
c.
Update
the
maximum
allowable
cost
list
within
seven
calendar
days
from
the
date
of
a
change
in
the
methodology,
or
a
change
in
the
value
of
a
variable
applied
in
the
methodology,
on
which
the
maximum
allowable
cost
list
is
based.
d.
Provide
a
reasonable
process
for
each
pharmacy
in
a
pharmacy
network
to
receive
prompt
notice
of
all
changes
to
the
maximum
allowable
cost
list
to
which
the
pharmacy
is
subject.
Sec.
9.
NEW
SECTION
.
510B.8C
Pharmacy
benefits
manager
affiliates
——
reimbursement.
A
pharmacy
benefits
manager
shall
not
reimburse
any
pharmacy
located
in
the
state
in
an
amount
less
than
the
amount
that
the
pharmacy
benefits
manager
reimburses
a
pharmacy
benefits
manager
affiliate
for
dispensing
the
same
prescription
drug
as
dispensed
by
the
pharmacy.
The
reimbursement
amount
shall
be
House
File
2384,
p.
8
calculated
on
a
per
unit
basis
based
on
the
same
generic
product
identifier
or
generic
code
number.
Sec.
10.
NEW
SECTION
.
510B.8D
Clean
claims.
After
the
date
of
receipt
of
a
clean
claim
submitted
by
a
pharmacy
in
a
pharmacy
network,
a
pharmacy
benefits
manager
shall
not
retroactively
reduce
payment
on
the
claim,
either
directly
or
indirectly
except
in
the
following
circumstances:
1.
The
claim
is
found
not
to
be
a
clean
claim
during
the
course
of
a
routine
audit.
2.
The
claim
submission
was
fraudulent.
3.
The
claim
submission
was
a
duplicate
submission
of
a
claim
for
which
the
pharmacy
had
already
received
payment.
Sec.
11.
Section
510B.9,
Code
2022,
is
amended
to
read
as
follows:
510B.9
Submission,
approval,
and
use
of
prior
Prior
authorization
form
.
A
pharmacy
benefits
manager
shall
file
with
and
have
approved
by
the
commissioner
a
single
prior
authorization
form
as
provided
in
section
505.26
comply
with
all
applicable
prior
authorization
requirements
pursuant
to
section
505.26
.
A
pharmacy
benefits
manager
shall
use
the
single
prior
authorization
form
as
provided
in
section
505.26
.
Sec.
12.
Section
510B.10,
Code
2022,
is
amended
by
striking
the
section
and
inserting
in
lieu
thereof
the
following:
510B.10
Enforcement.
1.
The
commissioner
may
take
any
enforcement
action
under
the
commissioner’s
authority
to
enforce
compliance
with
this
chapter.
2.
After
notice
and
hearing,
the
commissioner
may
issue
any
order
or
impose
any
penalty
pursuant
to
section
507B.7,
and
may
suspend
or
revoke
a
pharmacy
benefits
manager’s
certificate
of
registration
as
a
third-party
administrator
upon
a
finding
that
the
pharmacy
benefits
manager
violated
this
chapter,
or
any
applicable
requirements
pertaining
to
third-party
administrators
under
chapter
510.
3.
A
pharmacy
benefits
manager
shall
be
subject
to
the
commissioner’s
authority
to
conduct
an
examination
pursuant
to
chapter
507.
4.
A
pharmacy
benefits
manager
is
subject
to
the
House
File
2384,
p.
9
commissioner’s
authority
to
conduct
a
proceeding
pursuant
to
chapter
507B.
The
procedures
set
forth
in
chapter
507B
regarding
proceedings
shall
apply
to
a
proceeding
related
to
a
pharmacy
benefits
manager
under
this
chapter.
5.
A
pharmacy
benefits
manager
is
subject
to
the
commissioner’s
authority
to
conduct
an
examination,
audit,
or
inspection
pursuant
to
chapter
510
for
third-party
administrators.
The
procedures
set
forth
in
chapter
510
for
third-party
administrators
shall
apply
to
an
examination,
audit,
or
inspection
of
a
pharmacy
benefits
manager
under
this
chapter.
6.
If
the
commissioner
conducts
an
examination
of
a
pharmacy
benefits
manager
under
chapter
507;
a
proceeding
under
chapter
507B;
or
an
examination,
audit,
or
inspection
under
chapter
510,
all
information
received
from
the
pharmacy
benefits
manager,
and
all
notes,
work
papers,
or
other
documents
related
to
the
examination,
proceeding,
audit,
or
inspection
shall
be
confidential
records
pursuant
to
chapter
22
and
shall
be
accorded
the
same
confidentiality
as
notes,
work
papers,
investigatory
materials,
or
other
documents
related
to
the
examination
of
an
insurer
as
provided
in
section
507.14.
7.
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
3.
Sec.
13.
NEW
SECTION
.
510B.11
Rules.
The
commissioner
may
adopt
rules
pursuant
to
chapter
17A
to
administer
this
chapter.
Sec.
14.
NEW
SECTION
.
510B.12
Severability.
If
a
provision
of
this
chapter
or
its
application
to
any
person
or
circumstance
is
held
invalid,
the
invalidity
does
not
affect
other
provisions
or
applications
of
this
chapter
which
can
be
given
effect
without
the
invalid
provision
or
application,
and
to
this
end
the
provisions
of
this
chapter
are
severable.
Sec.
15.
REPEAL.
Section
510B.3,
Code
2022,
is
repealed.
Sec.
16.
APPLICABILITY.
This
division
of
this
Act
applies
to
pharmacy
benefits
managers
that
manage
a
prescription
drug
benefit
in
the
state
on
or
after
the
effective
date
of
this
Act.
DIVISION
II
House
File
2384,
p.
10
PHARMACY
BENEFITS
MANAGER
REPORTING
Sec.
17.
Section
510C.1,
Code
2022,
is
amended
to
read
as
follows:
510C.1
Definitions.
As
used
in
this
chapter
unless
the
context
otherwise
requires:
1.
“Administrative
fees”
means
a
fee
or
payment,
other
than
a
rebate,
under
a
contract
between
a
pharmacy
benefits
manager
and
a
pharmaceutical
drug
manufacturer
in
connection
with
the
pharmacy
benefits
manager’s
management
of
a
health
carrier’s
third-party
payor’s
prescription
drug
benefit,
that
is
paid
by
a
pharmaceutical
drug
manufacturer
to
a
pharmacy
benefits
manager
or
is
retained
by
the
pharmacy
benefits
manager.
2.
“Aggregate
retained
rebate
percentage”
means
the
percentage
of
all
rebates
received
by
a
pharmacy
benefits
manager
that
is
not
passed
on
to
the
pharmacy
benefits
manager’s
health
carrier
third-party
payor
clients.
3.
“Commissioner”
means
the
commissioner
of
insurance.
4.
“Covered
person”
means
the
same
as
defined
in
section
514J.102
510B.1
.
5.
“Formulary”
means
a
complete
list
of
prescription
drugs
eligible
for
coverage
under
a
health
benefit
plan.
6.
“Health
benefit
plan”
means
the
same
as
defined
in
section
514J.102
510B.1
.
7.
“Health
carrier”
means
the
same
as
defined
in
section
514J.102
510B.1
.
8.
“Health
carrier
administrative
service
fee”
means
a
fee
or
payment
under
a
contract
between
a
pharmacy
benefits
manager
and
a
health
carrier
in
connection
with
the
pharmacy
benefits
manager’s
administration
of
the
health
carrier’s
prescription
drug
benefit
that
is
paid
by
a
health
carrier
to
a
pharmacy
benefits
manager
or
is
otherwise
retained
by
a
pharmacy
benefits
manager.
9.
8.
“Pharmacy
benefits
manager”
means
a
person
who,
pursuant
to
a
contract
or
other
relationship
with
a
health
carrier,
either
directly
or
through
an
intermediary,
manages
a
prescription
drug
benefit
provided
by
the
health
carrier
the
same
as
defined
in
section
510B.1
.
10.
9.
“Prescription
drug
benefit”
means
a
health
benefit
House
File
2384,
p.
11
plan
providing
for
third-party
payment
or
prepayment
for
prescription
drugs
the
same
as
defined
in
section
510B.1
.
11.
10.
“Rebate”
means
all
discounts
and
other
negotiated
price
concessions
paid
directly
or
indirectly
by
a
pharmaceutical
manufacturer
or
other
entity,
other
than
a
covered
person,
in
the
prescription
drug
supply
chain
to
a
pharmacy
benefits
manager,
and
which
may
be
based
on
any
of
the
following:
the
same
as
defined
in
section
510B.1.
a.
A
pharmaceutical
manufacturer’s
list
price
for
a
prescription
drug.
b.
Utilization.
c.
To
maintain
a
net
price
for
a
prescription
drug
for
a
specified
period
of
time
for
the
pharmacy
benefits
manager
in
the
event
the
pharmaceutical
manufacturer’s
list
price
increases.
d.
Reasonable
estimates
of
the
volume
of
a
prescribed
drug
that
will
be
dispensed
by
a
pharmacy
to
covered
persons.
11.
“Third-party
payor”
means
the
same
as
defined
in
section
510B.1.
12.
“Third-party
payor
administrative
service
fee”
means
a
fee
or
payment
under
a
contract
between
a
pharmacy
benefits
manager
and
a
third-party
payor
in
connection
with
the
pharmacy
benefits
manager’s
administration
of
the
third-party
payor’s
prescription
drug
benefit
that
is
paid
by
a
third-party
payor
to
a
pharmacy
benefits
manager
or
is
otherwise
retained
by
a
pharmacy
benefits
manager.
Sec.
18.
Section
510C.2,
subsection
1,
unnumbered
paragraph
1,
Code
2022,
is
amended
to
read
as
follows:
Each
pharmacy
benefits
manager
shall
provide
a
report
annually
by
February
15
to
the
commissioner
that
contains
all
of
the
following
information
regarding
prescription
drug
benefits
provided
to
covered
persons
of
each
health
carrier
third-party
payor
with
whom
the
pharmacy
benefits
manager
has
contracted
during
the
prior
calendar
year:
Sec.
19.
Section
510C.2,
subsection
1,
paragraphs
c,
d,
e,
and
g,
Code
2022,
are
amended
to
read
as
follows:
c.
The
aggregate
dollar
amount
of
all
health
carrier
third-party
payor
administrative
service
fees
received
by
the
pharmacy
benefits
manager.
House
File
2384,
p.
12
d.
The
aggregate
dollar
amount
of
all
rebates
received
by
the
pharmacy
benefits
manager
that
the
pharmacy
benefits
manager
did
not
pass
through
to
the
health
carrier
third-party
payor
.
e.
The
aggregate
amount
of
all
administrative
fees
received
by
the
pharmacy
benefits
manager
that
the
pharmacy
benefits
manager
did
not
pass
through
to
the
health
carrier
third-party
payor
.
g.
Across
all
health
carrier
third-party
payor
clients
with
whom
the
pharmacy
benefits
manager
was
contracted,
the
highest
and
the
lowest
aggregate
retained
rebate
percentages.
Sec.
20.
Section
510C.2,
subsection
2,
paragraph
a,
subparagraph
(1),
Code
2022,
is
amended
to
read
as
follows:
(1)
The
identity
of
a
specific
health
carrier
third-party
payor
.
Sec.
21.
Section
510C.2,
subsection
2,
paragraph
b,
Code
2022,
is
amended
to
read
as
follows:
b.
Information
provided
under
this
section
by
a
pharmacy
benefits
manager
to
the
commissioner
that
may
reveal
the
identity
of
a
specific
health
carrier
third-party
payor
,
the
price
charged
by
a
specific
pharmaceutical
manufacturer
for
a
specific
prescription
drug
or
class
of
prescription
drugs,
or
the
amount
of
rebates
provided
for
a
specific
prescription
drug
or
class
of
prescription
drugs
shall
be
considered
a
confidential
record
and
be
recognized
and
protected
as
a
trade
secret
pursuant
to
section
22.7,
subsection
3
.
DIVISION
III
EMERGENCY
RULEMAKING
Sec.
22.
EMERGENCY
RULES.
The
insurance
division
of
the
department
of
commerce
may
adopt
emergency
rules
under
section
17A.4,
subsection
3,
and
section
17A.5,
subsection
2,
paragraph
“b”,
to
implement
the
provisions
of
this
Act
and
the
rules
shall
be
effective
immediately
upon
filing
unless
a
later
date
is
specified
in
the
rules.
Any
rules
adopted
in
accordance
with
this
section
shall
also
be
published
as
a
notice
of
intended
action
as
provided
in
section
17A.4.
DIVISION
IV
EFFECTIVE
DATE
House
File
2384,
p.
13
Sec.
23.
EFFECTIVE
DATE.
This
Act,
being
deemed
of
immediate
importance,
takes
effect
upon
enactment.
______________________________
PAT
GRASSLEY
Speaker
of
the
House
______________________________
JAKE
CHAPMAN
President
of
the
Senate
I
hereby
certify
that
this
bill
originated
in
the
House
and
is
known
as
House
File
2384,
Eighty-ninth
General
Assembly.
______________________________
MEGHAN
NELSON
Chief
Clerk
of
the
House
Approved
_______________,
2022
______________________________
KIM
REYNOLDS
Governor