Gov. Matt Meyer (D) signed into law SB 271, PBM reform legislation with wide-ranging provisions. The new law provides audit protections for pharmacies, limiting audits to no more than once every 12 months, setting parameters for wholesale invoice audits, and requiring audit costs to be borne by the PBM. It also strengthens requirements for appeals processes, including how an unsuccessful appeal with the PBM can be taken to the Department of Insurance. SB 271 has new provisions to protect pharmacies from PBM retaliation for appeals and complaints and prohibits PBMs from amending contracts without providing 60 days’ notice. It also prohibits requiring pharmacies to dispense a therapeutically equivalent or therapeutically alternative drug that costs the enrollee more out-of-pocket than the prescribed drug, unless the substitution is made for medical reasons.
NCPA salutes the Delaware Pharmacy Society (DPS) for its historically successful legislative session. In addition to the PBM reform bill, DPS priority bills SB 320 (broad prescriptive authority), SB 334 (uniform health care professional credentialing), and SB 180 (modernizing licensure and Board of Pharmacy operations) were also enacted.
