Amendment ID: S2499-1-R1

Redraft Amendment 1

Licensing and Regulation of PBMs

Messrs. Cronin and Tarr move that the proposed new draft be amended in section 33, by striking out, in lines 556 to 559, inclusive, the words “the amount of all rebates that the pharmacy benefit manager received from all pharmaceutical manufacturing companies for all health carrier clients in the aggregate and for each health carrier client or health plan sponsor individually, attributable to patient utilization in the commonwealth” and inserting in place thereof the following words:- “the amount of all rebates that the pharmacy benefit manager received from all pharmaceutical manufacturing companies: (A) for all health carrier clients in the aggregate; (B) for each health carrier client or health plan sponsor individually; and (C) by drug, for 30 of the most utilized drugs in the commonwealth as determined by the center”; and

in section 56, in proposed chapter 176Y of the General Laws, by adding the following section:-

“Section 4. (a) A pharmacy benefit manager shall not make payments to a pharmacy benefit consultant or broker whose services were obtained by a health plan sponsor to work on the pharmacy benefit bidding or contracting process if the payment constitutes a conflict of interest, as determined by the commissioner. For purposes of this section, payments from a pharmacy benefit manager to a pharmacy benefit consultant or broker shall include, but not be limited to: (i) shared rebates from pharmaceutical manufacturers; (ii) per prescription fees; (iii) per member fees; (iv) referral fees; (v) bonuses; or (vi) any other financial arrangement the commissioner considers to be a conflict of interest.

(b) The division shall adopt any written policies or procedures or promulgate regulations that the division determines are necessary to implement this section.”.