New Hampshire SB 478: relative to strengthening prescription drug affordability and pharmacy benefits manager accountability.

Bill Text

SB 478-FN - AS INTRODUCED

2026 SESSION

 26-2037

 05/08

SENATE BILL 478-FN

AN ACT relative to strengthening prescription drug affordability and pharmacy benefits manager accountability.

SPONSORS: Sen. McGough, Dist 11; Sen. Gannon, Dist 23; Sen. Rosenwald, Dist 13; Sen. Pearl, Dist 17; Sen. Birdsell, Dist 19; Sen. Innis, Dist 7; Rep. W. MacDonald, Rock. 16; Rep. Miles, Hills. 12; Rep. Potucek, Rock. 13; Rep. L. Walsh, Rock. 15; Rep. Cole, Hills. 26

COMMITTEE: Health and Human Services

─────────────────────────────────────────────────────────────────

ANALYSIS

 This bill regulates prescription drug costs and increases transparency and accountability by banning spread pricing, adopting pass through pricing, and ensuring all manufacturer rebates go toward lowering premiums or point-of sale costs. The bill also bans retroactive fees on clean claims, requires timely access to pricing lists, allows audits to prevent misuse, and prioritizes lowest net cost drugs.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 

Explanation: Matter added to current law appears in bold italics.

 Matter removed from current law appears [in brackets and struckthrough.]

 Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

 26-2037

 05/08

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty-Six

AN ACT relative to strengthening prescription drug affordability and pharmacy benefits manager accountability.

Be it Enacted by the Senate and House of Representatives in General Court convened:

 1 Statement of Purpose. 

 The general court finds that prescription drug affordability is essential to public health and that aligning incentives among manufacturers, pharmacy benefit managers (PBMs), health carriers, pharmacies, hospitals, and patients can reduce list-price inflation pressures, lower consumer out-of-pocket costs, and moderate premiums. The purpose of this act is to enhance transparency to the New Hampshire insurance department (NHID) while protecting competitively sensitive information, delink PBM compensation from drug prices in state-administered plans and make a delinked, pass-through option broadly available to employers, assure fair, competitive pharmacy networks without retroactive claim recoupments, protect 340B safety-net care from discriminatory reimbursement, promote clinically driven formularies with clear exceptions pathways, expand access to biosimilars and other lower-net-cost therapies, and offer consumers optional monthly out-of-pocket smoothing.

 2 Pharmacy Benefits Managers; Definitions. Amend RSA 402-N:1 is repealed and reenacted to read as follows: 

 402-N:1 Definitions. 

 In this chapter: 

 I. "Claims processing services" means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include: 

 (a) Receiving payments for pharmacist services. 

 (b) Making payments to pharmacists or pharmacies for pharmacist services. 

 II. "Commissioner" means the commissioner of the insurance department. 

 III. "Health carrier" means "health carrier" as defined in RSA 420-J:3, XXIII. 

 IV. "Pharmacist" means an individual licensed as a pharmacist by the pharmacy board. 

 V. "Pharmacist services" means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy. 

 VI. "Pharmacy" means the place licensed by the pharmacy board in which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or sold at retail. 

 VII. “Health plan” means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.

 VIII. “Insurer” means any health insurance issuer that is subject to state law regulating insurance and offers health insurance coverage, as defined in 42 U.S.C. section 300gg-91, or any state or local governmental employer plan.

 IX. “Person” includes a natural person, corporation, mutual company, unincorporated association, partnership, joint venture, limited liability company, trust, estate, foundation, not-for-profit corporation, unincorporated organization, government or governmental subdivision or agency.

 X. “Pharmacy benefit management fee” means a fee that covers the cost of providing one or more pharmacy benefit management services and that does not exceed the value of the service or services actually performed by the pharmacy benefit manager. 

 XI. “Pharmacy benefit management service” means: 

 (a) Negotiating the price of prescription drugs, including negotiating and contracting for direct or indirect rebates, discounts, or other price concessions; 

 (b) Managing any aspect of a prescription drug b