North Carolina SB 479: SCRIPT Act.

Bill Text

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025

SESSION LAW 2025-69
SENATE BILL 479

*S479-v-8*
AN ACT SUPPORTING COMMUNITY RETAIL PHARMACIES AND IMPROVING
TRANSPARENCY.

The General Assembly of North Carolina enacts:

PART I. PHARMACY OF CHOICE MODIFICATIONS
SECTION 1.1. G.S. 58-51-37 reads as rewritten:
"§ 58-51-37. Pharmacy of choice.
(a) This section shall apply to all health benefit plans providing pharmaceutical services
benefits, including prescription drugs, to any resident of North Carolina. This section shall also
apply to insurance companies and health maintenance organizations that provide or administer
coverages and benefits for prescription drugs. This section shall apply to pharmacy benefits
managers with respect to 340B covered entities and 340B contract pharmacies, as defined in
G.S. 58-56A-1. This section shall not apply to any entity that has its own facility, employs or
contracts with physicians, pharmacists, nurses, and other health care personnel, and that
dispenses prescription drugs from its own pharmacy to its employees and to enrollees of its health
benefit plan; provided, however, this section shall apply to an entity otherwise excluded that
contracts with an outside pharmacy or group of pharmacies to provide prescription drugs and
services. This section shall not apply to any federal program, clinical trial program, hospital or
other health care facility licensed pursuant to Chapter 131E or Chapter 122C of the General
Statutes, when dispensing prescription drugs to its patients.
(b) As used Definitions. – The following definitions apply in this section:
(1) "Copayment" means a type of cost sharing whereby insured or covered
persons pay a specified predetermined amount per unit of service with their
insurer paying the remainder of the charge. The copayment is incurred at the
time the service is used. The copayment may be a fixed or variable
amount.340B contract pharmacy. – As defined in G.S. 58-56A-1.
(2) "Contract provider" means a Contract provider. – A pharmacy granted the
right to provide prescription drugs and pharmacy services according to the
terms of the insurer.
(3) Copayment. – A type of cost-sharing in which an insured is required to pay a
specified predetermined amount, which is either fixed or variable, per unit of
service that is incurred at the time of service and in which the insurer pays the
remainder of the charge for that service.
(4) "Health Health benefit plan" is as that term is plan. – As defined in
G.S. 58-50-110(11).G.S. 58-3-167.
(5) Housing unit. – All of the following are considered housing units:
a. A house.
b. An apartment.
c. A mobile home or trailer.
d. A group of rooms or a single room that is occupied, or intended for
occupation, as separate living quarters, in which the occupants live

Page 2 Session Law 2025-69 Senate Bill 479
separately from any other persons in the building and have direct
access from the outside of the building or through a common hall.
(6) Independent pharmacy. – A pharmacy that is part of a group of 10 or fewer
pharmacies under common ownership, including a pharmacy that is part of a
group of one.
(7) Insured. – An individual covered by a health benefit plan.
(4)(8) "Insurer" means any entity that provides or offers a health benefit plan.Insurer.
– As defined in G.S. 58-3-167.
(9) Reserved for future codification purposes.
(5)(10) "Pharmacy" means a Pharmacy. – A pharmacy registered with the North
Carolina Board of Pharmacy.
(11) Pharmacy desert. – Either of the following areas:
a. An urban community or neighborhood without a pharmacy within a
2-mile radius of any point in the community or neighborhood.
b. A rural community without a pharmacy within a 15-mile radius of any
point in the community.
(12) Rural. – An open county or settlement with fewer than 5,000 residents or
2,000 housing units.
(13) Urban. – A densely developed area with at least 5,000 residents or 2,000
housing units.
(b1) Applicability. – This section applies to insurers offering health benefit plans that
include prescription drug or pharmacy benefits. This section shall also apply to pharmacy benefits
managers in the same way that it applies to insurers with respect to 340B covered entities and
340B contract pharmacies. This section does not apply to any federal program or clinical trial
program, hospital, or other health care facility licensed pursuant to Chapter 131E or Chapter
122C of the General Statutes, when dispensing prescription drugs to its patients.
(c) The terms of a health benefit plan shall not:Prohibitions. – An insurer shall not do any
of the following:
(1) Prohibit or limit a resident of this State, an insured who is eligible for
reimbursement for pharmacy services as a participant or beneficiary of a
health benefit plan, from selecting a pharmacy of his or her the insured's
choice when the pharmacy has agreed to participate in the health benefit plan
according to the terms offered by the insurer;insurer.
(2) Deny a pharmacy the opportun