HOUSE JUDICIARY COMMITTEE SUBSTITUTE FOR

HOUSE HEALTH AND HUMAN SERVICES COMMITTEE SUBSTITUTE FOR

HOUSE BILL 540

56th legislature - STATE OF NEW MEXICO - first session, 2023

 

 

 

 

 

 

 

AN ACT

RELATING TO THE PUBLIC PEACE, HEALTH, SAFETY AND WELFARE; ENACTING A NEW SECTION OF THE NEW MEXICO INSURANCE CODE TO PROHIBIT DISCRIMINATION AGAINST ENTITIES PARTICIPATING IN THE FEDERAL 340B DRUG PRICING PROGRAM; DECLARING AN EMERGENCY.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. A new section of the New Mexico Insurance Code is enacted to read:

     "[NEW MATERIAL] PROHIBITION ON DISCRIMINATION AGAINST A COVERED ENTITY.--

          A. As used in this section:

                (1) "340B drug" means a drug that is purchased at a discount in accordance with the 340B program requirements;

                (2) "340B program" means the federal drug pricing program created pursuant to 42 U.S.C. Section 256b;

                (3) "covered entity" means an entity participating in the 340B program; and

                (4) "pharmacy benefits manager" means an entity that provides pharmacy benefits management services.

          B. A pharmacy benefits manager or a third party shall not discriminate against a covered entity on the basis of its participation in the 340B program by:

                (1) reimbursing a covered entity for a 340B drug at a rate lower than that paid for the same drug to pharmacies, similar in prescription volume, that are non-covered entities;

                (2) assessing a fee, chargeback or other adjustment to the covered entity that is not assessed to non-covered entities;

                (3) imposing a provision that prevents or interferes with a person's choice to receive 340B drugs from a covered entity; or

                (4) imposing terms or conditions that differ from terms or conditions imposed on a non-covered entity, including:

                     (a) restricting or requiring participation in a pharmacy network;

                     (b) requiring more frequent auditing or a broader scope of audit for inventory management systems using generally accepted accounting principles;

                     (c) requiring a covered entity to reverse, resubmit or clarify a claim after the initial adjudication, unless these actions are in the normal course of pharmacy business and not related to the 340B program; or

                     (d) charging an additional fee or provision that prevents or interferes with an individual's choice to receive a 340B drug from a covered entity."

     SECTION 2. EMERGENCY.--It is necessary for the public peace, health and safety that this act take effect immediately.

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