Pennsylvania SB 1110: An Act providing for consumer prescription drug pricing disclosure.

Bill Text

2017-2018 Regular Session SB 1110 PN 1926 Bill Text (HTM) 

• 

• 

 See other bills 
under the
same topic 

PRINTER'S NO. 1926 

THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL 

No.

1110 

Session of 

2018 

INTRODUCED BY AUMENT, WARD, MARTIN, ARGALL, LANGERHOLC, FOLMER, 

RAFFERTY, KILLION, SCHWANK, RESCHENTHALER, MENSCH, 

McGARRIGLE, BAKER, BROWNE AND REGAN, JUNE 22, 2018 

REFERRED TO BANKING AND INSURANCE, JUNE 22, 2018 

AN ACT

Providing for consumer prescription drug pricing disclosure.

The General Assembly of the Commonwealth of Pennsylvania 

hereby enacts as follows:

Section 1. Short title.

This act shall be known and may be cited as the Consumer 

Prescription Drug Pricing Disclosure Act.

Section 2. Definitions.

The following words and phrases when used in this act shall 

have the meanings given to them in this section unless the 

context clearly indicates otherwise:

"Covered entity." A member, participant, enrollee, 

contractholder or policyholder providing pharmacy benefits to a 

covered individual under a health coverage plan pursuant to a 

contract administered by a pharmacy benefit manager.

"Covered individual." A member, participant, enrollee, 

contractholder or policyholder or beneficiary of a covered 

entity who is provided health coverage by the covered entity. 

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

The term includes a dependent or other person provided health 

coverage through the policy, contract or plan of a covered 

individual.

"Pharmacist." As defined in section 2(10) the act of 

September 27, 1961 (P.L.1700, No.699), known as the Pharmacy 

Act.

"Pharmacy." As defined in section 2(12) of the Pharmacy Act.

"Pharmacy benefits management." Any of the following:

(1) Procurement of prescription drugs at a negotiated 

contracted rate for distribution within this Commonwealth to 

covered individuals.

(2) Administration or management of prescription drug 

benefits provided by a covered entity for the benefit of 

covered individuals.

(3) Administration of pharmacy benefits, including:

(i) Operating a mail-service pharmacy.

(ii) Claims processing.

(iii) Managing a retail pharmacy network management.

(iv) Paying claims to pharmacies for prescription 

drugs dispensed to covered individuals via retail or 

mail-order pharmacy.

(v) Developing and managing a clinical formulary, 

utilization management and quality assurance programs.

(vi) Rebate contracting and administration.

(vii) Managing a patient compliance, therapeutic 

intervention and generic substitution program.

(viii) Operating a disease management program.

(ix) Setting pharmacy reimbursement pricing and 

methodologies, including maximum allowable cost, and 

determining single or multiple source drugs.

20180SB1110PN1926 - 2 - 

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

"Pharmacy benefits manager." A person, business or other 

entity that performs pharmacy benefits management.

Section 3. Disclosure of prescription drug costs.

(a) Information to covered individual.--A pharmacy or 

pharmacist shall have the right to provide a covered individual 

with information concerning the cost of a prescription drug, 

including the individual's cost share.

(b) No prohibition or penalization.--Neither a pharmacy nor 

a pharmacist shall be prohibited from or penalized by a pharmacy 

benefits manager for discussing the information under subsection 

(a), disclosing the availability of any therapeutically 

equivalent alternative medications or selling to the covered 

individual a more affordable alternative if an affordable 

alternative is available.

Section 4. Effective date.

This act shall take effect in 60 days.

20180SB1110PN1926 - 3 - 

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16