Pharmacy benefit managers
PHARMACY BENEFIT MANAGERS – Amends existing law to establish provisions governing pharmacy benefit managers.

RS31085 / H0596

Pharmacy Benefit Managers (PBM) are third party administrators under contract by health/prescription plans, employers and government entities to manage prescription drug programs for health plan recipients. PBMs administer the prescription drug benefit for nearly every public and private health plan in the United States. PBMs decide which pharmacies are included in a prescription drug plan's network and how much the pharmacy will be paid for dispensing services.

The purpose of this legislation is to establish parameters and standards for how Pharmacy Benefit Managers operate in Idaho, requiring fairness, transparency and free market operations; things all other businesses in Idaho must operate under, but on which Idaho’s law remains silent for PBMs.

This legislation adds new definitions; lays out requirements that make contracts with pharmacies transparent and fair; requires PBMs to provide transparent pricing on drugs; and requires PBMs to report to the Department of Insurance in a transparent way. PBMs already operate under these provisions in other states; these additions will help protect Idahoans’ health care dollars as well.

The legislation has a fiscal impact of $132,400 for the Department of Insurance to hire one FTP with specialization in this area to have oversight on compliance and investigate complaints.

Bill Events
Date Description
02/19 Introduced, read first time, referred to JRA for Printing
02/20 Reported Printed and Referred to Health & Welfare
02/27 Reported out of Committee with Do Pass Recommendation, Filed for Second Reading
02/28 Read second time; Filed for Third Reading
02/29 U.C. to hold place on third reading calendar until Monday, March 4, 2024
03/04 U.C. to place at bottom of House bills of third reading calendar one legislative day
03/05 U.C. to hold place on third reading calendar one legislative day
03/06 Read Third Time in Full – PASSED - 41-29-0
AYES – Achilles, Allgood, Andrus, Berch, Boyle, Cannon, Cheatum, Chew(Schmick), Clow, Crane(12), Crane(13), Dixon(1), Durrant, Ehardt, Erickson, Furniss, Handy, Healey, Hill, Holtzclaw, Horman, Kingsley, Manwaring, Mathias(Church), Miller, Mitchell, Monks, Necochea, Palmer(Johnson), Pickett, Raymond, Redman, Roberts, Rubel, Sauter, Shepherd, Vander Woude, Weber, Wroten, Young, Mr. Speaker
NAYS – Alfieri, Barbieri, Blanksma, Bundy, Burns, Cornilles, Dixon(24), Ehlers, Galaviz, Gallagher, Gannon, Garner, Green, Hawkins, Lambert, Lanting, McCann, Mendive, Mickelsen, Nelsen, Petzke, Price, Raybould, Scott, Skaug, Tanner, Wheeler, Wisniewski, Yamamoto
Absent – None
Floor Sponsor - Redman
Title apvd - to Senate
03/07 Received from the House passed; filed for first reading
03/07 Introduced, read first time; referred to: Health & Welfare
03/14 Reported out of committee; to 14th Order for amendment
03/19 Placed in the Committee of the Whole
03/19 Amendments ordered printed
03/19 Reported out as amended; filed for first reading
03/19 Amendments reported printed
03/19 Read first time as amended in the Senate; Filed for Second Reading
03/19 Rules Suspended (2/3 Vote - Read in full as required) – PASSED - 27-8-0
AYES – Adams, Anthon, Bernt, Bjerke, Burtenshaw, Cook, Den Hartog, Foreman, Grow, Guthrie, Harris, Hartgen, Just, Lakey, Lee, Lent, Rabe, Ricks, Ruchti, Schroeder, Semmelroth, Taylor, Trakel, VanOrden, Ward-Engelking, Winder, Wintrow
NAYS – Carlson, Hart, Herndon, Lenney, Nichols, Okuniewicz, Toews, Zuiderveld
Absent and excused – None
Floor Sponsor - Cook
Title apvd - to House
03/20 Returned from the Senate Amended
03/20 Referred to Health & Welfare for concurrence recommendation
03/21 Reported out of Committee and Recommend Concurrence
03/21 House Concurred in Senate Amendments
03/21 Bills as Amended Referred to JRA for Engrossing
03/21 Reported Engrossed; Filed for First Reading of Engrossed Bills
03/21 Read first time as amended in Senate; Filed for Second Reading
03/22 Read second time as amended in Senate; Filed for Third Reading
03/25 Read third time in full as amended in Senate – PASSED - 53-15-2
AYES – Achilles, Allgood, Andrus, Blanksma, Boyle, Bundy, Cannon, Cheatum, Chew(Harada), Clow, Cornilles, Crane(12), Crane(13), Dixon(1), Dixon(24), Durrant, Ehardt, Erickson, Furniss, Galaviz, Gannon, Garner, Handy, Healey, Hill, Holtzclaw(Johnson), Kingsley, Lanting, Manwaring, McCann, Mickelsen, Miller, Mitchell, Monks, Necochea, Nelsen, Palmer, Petzke, Pickett, Raybould, Raymond, Redman, Roberts, Rubel, Sauter, Shepherd, Vander Woude, Weber(Weber), Wheeler, Wroten, Yamamoto, Young, Mr. Speaker
NAYS – Alfieri, Barbieri, Berch, Ehlers, Gallagher, Green, Hawkins, Lambert, Mathias, Mendive, Price, Scott, Skaug, Tanner, Wisniewski
Absent – Burns, Horman
Floor Sponsor - Redman
Title apvd - to enrol
03/26 Reported Enrolled; Signed by Speaker; Transmitted to Senate
03/26 Received from the House enrolled/signed by Speaker
03/26 Signed by President; returned to House
03/26 Returned Signed by the President; Ordered Transmitted to Governor
03/27 Delivered to Governor at 4:15 p.m. on March 26, 2024
04/02 Reported Signed by Governor on April 1, 2024
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