Health insurance; retail community pharmacies. (HB943)

Introduced By

Del. Keith Hodges (R-Urbanna)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Health insurance; retail community pharmacies. Requires a carrier to administer its health benefit plans in a manner consistent with certain requirements and to include such requirements in its provider contracts addressing the provision of pharmacy benefits management. The bill provides that (i) a covered individual is permitted to fill any mail order-covered prescription, at the covered individual's option, at any mail order pharmacy or network participating retail community pharmacy under certain conditions; (ii) the carrier or pharmacy benefits manager is prohibited from imposing a differential copayment, additional fee, rebate, bonus, or other condition on any covered individual who elects to fill his prescription at an in-network retail community pharmacy that is not similarly imposed on covered individuals electing to fill a prescription from a mail order pharmacy; and (iii) the pharmacy benefits manager is required to expressly disclose to the carrier in the contract if the pharmacy benefits manager retains all or a greater portion of a drug manufacturer's rebate amount or any additional direct or indirect remuneration from any third party for drugs dispensed through the pharmacy benefits manager-owned mail order pharmacy than the pharmacy benefits manager does for drugs dispensed through a retail community pharmacy. The bill also removes the exemption for a self-insured or self-funded employee welfare benefit plan under provisions regulating pharmacy benefits managers. Read the Bill »


01/26/2022: Awaiting a Vote in the Health, Welfare and Institutions Committee


01/12/2022Prefiled and ordered printed; offered 01/12/22 22101739D
01/12/2022Referred to Committee on Health, Welfare and Institutions
01/26/2022Assigned HWI sub: Subcommittee #3
02/08/2022Subcommittee recommends continuing to 2023
02/10/2022Continued to 2023 in Health, Welfare and Institutions

Duplicate Bills

The following bills are identical to this one: HB560.

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