New Hampshire SB 547: relative to regulation and transparency of pharmacy benefit manager practices.

Bill Text

SB 547-FN - AS INTRODUCED

2026 SESSION

 26-2130

 05/09

SENATE BILL 547-FN

AN ACT relative to regulation and transparency of pharmacy benefit manager practices.

SPONSORS: Sen. Rosenwald, Dist 13; Sen. Rochefort, Dist 1; Sen. McGough, Dist 11; Sen. Fenton, Dist 10; Sen. Watters, Dist 4; Sen. Altschiller, Dist 24; Sen. Perkins Kwoka, Dist 21; Rep. Miles, Hills. 12; Rep. Nagel, Belk. 6; Rep. Weber, Ches. 5; Rep. Burroughs, Carr. 2; Rep. M. Pearson, Rock. 34

COMMITTEE: Health and Human Services

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ANALYSIS

 This bill amends the definitions of pharmacy benefit manager and rebate and adds additional terms governing pharmacy benefit manager business practices. The bill states that pharmacy benefit managers have a fiduciary duty to the health carrier client and are prohibited from retaining any portion of spread pricing.

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 Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

 26-2130

 05/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty-Six

AN ACT relative to regulation and transparency of pharmacy benefit manager practices.

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

 1 Findings. The general court finds better regulation of the pharmaceutical market to be in the public interest for the following reasons: 

 I. Prescription drug costs are a major driver of health care spending in New Hampshire, accounting for 23 percent of total health care expenditures in commercial insurance;

 II. There is a lack of meaningful competition, with the top 3 largest pharmacy benefit managers (PBMs) managing 80 percent of prescription drug claims;

 III. In the aggregate, the big 3 PBMs generate significant income on certain generic drugs from spread pricing, billing plan sponsor clients more than they reimburse pharmacies for drugs;

 IV. Highly concentrated and vertically integrated PBM-insurer-pharmacy entities have the ability and incentive to offer preferential treatment to their affiliated businesses, which may disadvantage unaffiliated and independent New Hampshire pharmacies and increase prescription drug costs;

 V. While the prescription drug supply chain has competitive elements, the lack of visibility into pricing structures, negotiations, and distribution channels prevents a full understanding of how well those market forces operate in New Hampshire; 

 VI. Increased transparency is an essential prerequisite for ensuring affordability, fiscal discipline, and informed decision-making;

 VII. Over half of New Hampshire residents are worried about affording their prescription medications;

 VIII. More than 25 percent of residents skip doses, cut pills in half, or do not fill prescriptions at all due to cost concerns.

 2 Pharmacy Benefit Managers; Definitions. Amend RSA 402-N:1 to read as follows: 

 402-N:1 Definitions. 

 In this chapter: 

 I. “Affiliate” of, or “affiliated” with, a specific person or other corporate entity means a person or other corporate entity that directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, the person or other corporate entity specified. 

 I-a. "Aggregate retained rebate ratio" means the sum total dollar amount of all rebates received from a manufacturer or other entity by a pharmacy benefit manager for prescription drug utilization by covered persons which is not passed on to the pharmacy benefit manager's health carrier clients or affiliates divided by the sum total dollar amount of all rebates received from a manufacturer or other entity by a pharmacy benefit manager for prescription drug utilization by covered persons of a pharmacy benefit manager’s health carrier clients or affiliates. 

 I-a. "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. 

 II-b. "Cost share/cost sharing" means the amount paid by a covered person as required under the covered person's health benefit plan.

 II-c. "Covered person" means "covered person" as defined in RSA 420-J:3.

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

 IV. "Health benefit plan" means "health benefit plan" as defined in RSA 420-J:3, XIX. 

 IV-a. "Mail order pharmacy" means a pharmacy whose primary business is to receiv