Iowa HSB99 regulates pharmacy benefits managers, ensuring fair pricing and reimbursement practices.

Iowa HSB99 introduces regulations for pharmacy benefits managers (PBMs) to ensure fair pricing and reimbursement practices. The bill mandates that PBMs use pass-through pricing unless specific conditions are met. It prohibits PBMs from imposing additional fees or cost-sharing based on the pharmacy chosen by the patient. PBMs must also provide a process for pharmacies to appeal reimbursement rates. The bill applies to PBMs managing prescription drug benefits in Iowa from July 1, 2025.

Iowa HSB99 regulates pharmacy benefits managers, ensuring fair pricing and reimbursement practices.

Iowa HSB99 introduces regulations for pharmacy benefits managers (PBMs) to ensure fair pricing and reimbursement practices. The bill mandates that PBMs use pass-through pricing unless specific conditions are met. It prohibits PBMs from imposing additional fees or cost-sharing based on the pharmacy chosen by the patient. PBMs must also provide a process for pharmacies to appeal reimbursement rates. The bill applies to PBMs managing prescription drug benefits in Iowa from July 1, 2025.