Pennsylvania Gov. Josh Shapiro (D) signed into law HB 1993, sweeping PBM reform legislation applicable to health plans not exempted by ERISA. Among its many provisions, the law addresses patient steering, requires reimbursement parity with PBM-owned or affiliated pharmacies, defines specialty drugs and specialty pharmacy, ensures network adequacy, limits audit error recoupment, strengthens PBM reporting, and provides broad oversight and enforcement authority to the Pennsylvania Department of Insurance. During the legislative process, the bill was amended to include pharmacy services provisions such as permitting pharmacists to administer flu and COVID-19 immunizations to patients 5 years and up; all other immunizations may be administered to patients 8 years and older. For more information and backstory about the bill, including its staggered effective dates, please see Shapiro’s press release.
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