South Carolina H4795 establishes requirements for pharmacy benefits managers to modify drug coverage in health benefit plans.

South Carolina H4795 amends the state code to add requirements for drug coverage modifications by pharmacy benefits managers. The bill specifies that modifications affecting drug coverage, such as removing a drug from a formulary or imposing a step-therapy restriction, must be uniformly applied among all group health benefit plan sponsors with identical or substantially identical plans. The issuer must provide written notice of the modification to the commissioner, plan sponsors, enrollees, and plan holders at least 60 days before the modification takes effect.

South Carolina H4795 establishes requirements for pharmacy benefits managers to modify drug coverage in health benefit plans.

South Carolina H4795 amends the state code to add requirements for drug coverage modifications by pharmacy benefits managers. The bill specifies that modifications affecting drug coverage, such as removing a drug from a formulary or imposing a step-therapy restriction, must be uniformly applied among all group health benefit plan sponsors with identical or substantially identical plans. The issuer must provide written notice of the modification to the commissioner, plan sponsors, enrollees, and plan holders at least 60 days before the modification takes effect.