Trial Engrossment of Amendment A05243 to House Bill 1993 P.N. 3317, Regular Session 2023-2024

A05243

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No.

1993

Session of

2024

INTRODUCED BY BENHAM, GAYDOS, KENYATTA, BURGOS, HARKINS,

DONAHUE, MADDEN, MAJOR, SANCHEZ, CERRATO, HILL-EVANS,

D'ORSIE, CIRESI, GREEN, DALEY, MATZIE, SOLOMON, MIHALEK,

ECKER, McNEILL, SCHLOSSBERG, PICKETT, PISCIOTTANO, WEBSTER,

HOHENSTEIN, KRUEGER, BOROWSKI, NEILSON, FEE, KIM, KHAN,

BERNSTINE, MENTZER, O'MARA, FLEMING, GROVE, MULLINS,

KOSIEROWSKI, ISAACSON, HEFFLEY, OBERLANDER, ARMANINI,

GREGORY, E. NELSON, STAATS, WAXMAN, STEELE, SALISBURY,

KINKEAD, McANDREW, KAUFFMAN, GIRAL, DELOZIER, FRITZ,

MUSTELLO, POWELL, D. WILLIAMS, HOGAN, CAUSER, FRIEL, SIEGEL,

WARNER AND COOPER, APRIL 3, 2024

AS REPORTED FROM COMMITTEE ON HEALTH, HOUSE OF REPRESENTATIVES,

AS AMENDED, JUNE 12, 2024

AN ACT

Amending the act of November 21, 2016 (P.L.1318, No.169),

entitled "An act providing for pharmacy audit procedures, for

registration of pharmacy benefits managers and auditing

entities, for maximum allowable cost transparency and for

prescription drugs reimbursed under the PACE and PACENET

program; and making related repeals," further providing for

title of act; in preliminary provisions, further providing

for short title and for definitions; in pharmacy audits,

further providing for limitations; and IN REGISTRATION,

FURTHER PROVIDING FOR PBM AND AUDITING ENTITY REGISTRATION;

providing for pharmacy benefits manager contract requirements

and prohibited acts.; IN PBM COST TRANSPARENCY REQUIREMENTS,

PROVIDING FOR TRANSPARENCY REPORT REQUIRED; AND, IN

ENFORCEMENTS, FURTHER PROVIDING FOR SCOPE OF ENFORCEMENT

AUTHORITY AND PROVIDING FOR REGULATIONS AND FOR CONSTRUCTION.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1. The title and section 101 of the act of November

21, 2016 (P.L.1318, No.169), known as the Pharmacy Audit

Integrity and Transparency Act, are amended to read:

AN ACT

Providing for pharmacy audit procedures, for registration of

pharmacy benefits managers and auditing entities, for maximum

allowable cost transparency and for prescription drugs

reimbursed under the PACE and PACENET program and for

pharmacy benefit managers contract requirements and

prohibited activities; and making related repeals.

Section 101. Short title.

This act shall be known and may be cited as the [Pharmacy

Audit Integrity and Transparency] Community Pharmacy Protection

PHARMACY BENEFIT REFORM Act.

Section 2. Section 103 of the act is amended by adding

definitions to read:

SECTION 2. THE DEFINITIONS OF "COVERED ENTITY" AND "HEALTH

INSURANCE POLICY" IN SECTION 103 OF THE ACT ARE AMENDED AND THE

SECTION IS AMENDED BY ADDING DEFINITIONS TO READ:

Section 103. 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:

* * *

" Brand effective rate." The reimbursement rate paid to the

pharmacy based on a percentage of the average wholesale cost for

brand-name drugs dispensed by the pharmacy under the contract

with the pharmacy benefit manager.

* * *

"COVERED ENTITY." A CONTRACT HOLDER OR POLICY HOLDER

PROVIDING PHARMACY BENEFITS TO A COVERED INDIVIDUAL UNDER A

HEALTH [INSURANCE POLICY] BENEFIT PLAN PURSUANT TO A CONTRACT

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ADMINISTERED BY A PHARMACY BENEFIT MANAGER.

* * *

"Effective rate contract." A contract that sets a specific

discount rate for all prescriptions filled by a member pharmacy

during the term of the contract.

* * *

"Generic effective rate." The reimbursement rate paid to the

pharmacy based on a percentage of the average wholesale cost for

generic drugs dispensed by the pharmacy under the contract with

the pharmacy benefit manager.

* * *

"Patient steering." One of the following:

(1) When a pharmacy benefit manager directs a patient to

use a preferred pharmacy through mandatory mail order

requirements or the creation by the PBM of a restricted

network that consists only of pharmacies approved by the PBM.

(2) The use of co-pay differentials between PBM-

affiliated pharmacies and nonaffiliated pharmacies.

* * *

"Spread pricing." An act of a pharmacy benefit manager

reimbursing a pharmacy for a prescription and then billing an

insurer or an employer that provides health insurance at a

higher price for the same prescription.

"HEALTH BENEFIT PLAN." A POLICY, CONTRACT, CERTIFICATE OR

AGREEMENT ENTERED INTO, OFFERED, ISSUED OR RENEWED BY A HEALTH

INSURER TO PROVIDE, DELIVER, ARRANGE FOR, PAY FOR OR REIMBURSE

ANY OF THE COSTS OF PHYSICAL, MENTAL OR BEHAVIORAL HEALTH CARE

SERVICES. THE TERM DOES NOT INCLUDE MEDICARE SUPPLEMENT OR

CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE UNIFORMED SERVICES

(CHAMPUS) SUPPLEMENT INSURANCE.

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* * *

["HEALTH INSURANCE POLICY." A POLICY, SUBSCRIBER CONTRACT,

CERTIFICATE OR PLAN THAT PROVIDES PRESCRIPTION DRUG COVERAGE.

THE TERM INCLUDES BOTH COMPREHENSIVE AND LIMITED BENEFIT HEALTH

POLICIES.]

* * *

"LICENSEE." AN ENTITY SUBJECT TO OVERSIGHT OF THE DEPARTMENT

UNDER THIS ACT. THE TERM INCLUDES:

(1) AN AUDITING ENTITY.

(2) A HEALTH INSURER.

(3) A PHARMACY BENEFIT MANAGER.

* * *

"MONETARY ADVANTAGE OR PENALTY." AN INCENTIVE OR DETERRENT

IMPOSED UNDER A HEALTH BENEFIT PLAN THAT AFFECTS A BENEFICIARY'S

CHOICE OF PHARMACY. THE TERM INCLUDES, BUT IS NOT LIMITED TO, A

HIGHER COPAYMENT, A WAIVER OF A COPAYMENT, A REDUCTION IN

REIMBURSEMENT FOR SERVICES, A REQUIREMENT OR LIMIT ON THE NUMBER

OF DAYS OF A DRUG SUPPLY FOR WHICH REIMBURSEMENT WILL BE ALLOWED

OR A PROMOTION OF ONE PARTICIPATING PHARMACY OVER ANOTHER BY

THESE METHODS.

* * *

"SPREAD PRICING." A MODEL OF PRESCRIPTION DRUG PRICING IN

WHICH THE PBM CHARGES A HEALTH BENEFIT PLAN OR HEALTH INSURER A

CONTRACTED PRICE FOR PRESCRIPTION DRUGS AND THE CONTRACTED PRICE

FOR THE PRESCRIPTION DRUGS DIFFERS FROM THE AMOUNT THE PBM

DIRECTLY OR INDIRECTLY PAYS THE PHARMACIST OR PHARMACY FOR

PRESCRIPTION DRUGS AND RELATED PHARMACIST SERVICES.

Section 3. Section 303 of the act is amended by adding a

subsection to read:

Section 303. Limitations.

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* * *

SCRIVENER'S error made by a pharmacy not attributed to fraud,

waste or abuse that is discovered during an audit of the

pharmacy by the PBM shall result in the PBM recouping the

dispensing fee for that particular transaction, not the entire

amount of FOR the medication received by the patient.

SECTION 4. SECTION 501(B)(3) OF THE ACT IS AMENDED TO READ:

SECTION 501. PBM AND AUDITING ENTITY REGISTRATION.

* * *

(B) TERM AND FEE.--

* * *

(3) THE AMOUNT OF THE INITIAL APPLICATION FEE AND

RENEWAL APPLICATION FEE SHALL BE SUFFICIENT TO FUND THE

DEPARTMENT'S DUTIES IN RELATION TO ITS RESPONSIBILITIES UNDER

THIS [CHAPTER] act BUT MAY NOT EXCEED [$1,000] $10,000.

* * *

Section 4 5. The act is amended by adding a chapter to read:

CHAPTER 6

PHARMACY BENEFITS MANAGER CONTRACT

REQUIREMENTS AND PROHIBITED ACTS

Section 601. Contract provisions.

A contract between a pharmacy benefit manager PBM or a

designee of the pharmacy benefit manager PBM and a pharmacy may

not:

(1) Require participation in the PBM's network

contingent on the pharmacy signing either an effective rate

contract or a contract based on the National Average Drug

Acquisition Cost guidelines.

(2) Include provisions allowing for retroactive

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recoupment of money paid to a pharmacy by the PBM, unless

both parties agree to that provision.

(3) Base reimbursement upon general generic effective

rate or the brand effective rate as a condition of entering a

network, unless both parties agree to that provision. Any

additional fees must be disclosed and applied at the time of

the adjudication of the claim in writing 30 days prior to

initiation of the additional fees . Fees may include:

(i) Transaction fees.

(ii) Chargebacks due to recalculation of the cost of

the ingredients used in a prescription drug.

(iii) Adjustments in the general generic effective

rate, brand effective rates or direct and indirect

remuneration fees made by the PBM.

Section 602. Spread pricing participation prohibited.

A pharmacy benefit manager may not conduct or participate in

spread pricing.

Section 603. Patient steering prohibited.

A pharmacy benefit manager may not conduct or participate in

patient steering.

Section 604. Duties of the department.

The department shall:

(1) Develop a process for receiving, hearing and

resolving complaints a pharmacy filed against a PBM.

(2) Have the ability to set fixed amounts for PBM claim

processing fees and administrative fees.

(3) Develop a Statewide National Average Drug

Acquisition Cost guideline that uses wholesale pricing based

on manufacturer's invoices of those manufacturers who ship

drugs to this Commonwealth.

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Section 605. Duties of pharmacy benefit managers.

Pharmacy benefit managers shall:

(1) Approve a request from a pharmacy to be a member of

the PBM's network within 30 days of the initial request to

join the network.

(2) Provide a dedicated telephone number and email

address for handling network admission requests.

Section 606. PBM for State Employee Health Plan.

A PBM hired for the State Employee Health Plan shall have a

transparent reimbursement methodology based on the National

Average Drug Acquisition Cost guidelines developed under

section 604(3) and a dispensing fee equal to or greater than the

maximum prevailing fee for service or PACE rate in this

Commonwealth.

Section 607. Reports by PBM.

A PBM shall report to the department the amount of rebates

and payments received from drug manufacturers and how the

rebates and payments were distributed by the PBM.

A HEALTH BENEFIT PLAN, HEALTH INSURER OR PBM CONTRACTING WITH

A HEALTH BENEFIT PLAN OR HEALTH INSURER MAY NOT UTILIZE ANY FORM

OF SPREAD PRICING IN THIS COMMONWEALTH.

SECTION 603. PATIENT STEERING PROHIBITED.

A HEALTH BENEFIT PLAN, HEALTH INSURER OR PBM CONTRACTING WITH

A HEALTH BENEFIT PLAN OR HEALTH INSURER MAY NOT:

(1) REQUIRE A COVERED INDIVIDUAL, AS A CONDITION OF

PAYMENT OR REIMBURSEMENT, TO PURCHASE PHARMACIST SERVICES,

INCLUDING, BUT NOT LIMITED TO, PRESCRIPTION DRUGS,

EXCLUSIVELY THROUGH A MAIL-ORDER PHARMACY OR PBM AFFILIATE.

(2) PROHIBIT OR LIMIT ANY COVERED INDIVIDUAL FROM

SELECTING AN IN-NETWORK PHARMACY OR IN-NETWORK PHARMACIST OF

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THE COVERED INDIVIDUAL'S CHOICE WHO MEETS AND AGREES TO THE

TERMS AND CONDITIONS, INCLUDING REIMBURSEMENTS, IN THE PBM'S

CONTRACT.

(3) IMPOSE A MONETARY ADVANTAGE OR PENALTY UNDER A

HEALTH BENEFIT PLAN THAT AFFECTS A COVERED INDIVIDUAL'S

CHOICE OF PHARMACY AMONG THOSE PHARMACIES THAT HAVE CHOSEN TO

CONTRACT WITH THE PBM UNDER THE SAME TERMS AND CONDITIONS,

INCLUDING REIMBURSEMENTS.

(4) USE A COVERED INDIVIDUAL'S PHARMACY SERVICES DATA

COLLECTED UNDER CLAIMS PROCESSING SERVICES FOR THE PURPOSE OF

SOLICITING, MARKETING OR REFERRING THE COVERED INDIVIDUAL TO

A MAIL-ORDER PHARMACY OR PBM AFFILIATE, EXCEPT THAT A HEALTH

BENEFIT PLAN OR HEALTH INSURER MAY USE PHARMACY SERVICES DATA

FOR THE PURPOSE OF ADMINISTERING THE HEALTH BENEFIT PLAN.

SECTION 604. CLAWBACKS PROHIBITED.

(A) GENERAL RULE.--A HEALTH BENEFIT PLAN, HEALTH INSURER OR

PBM CONTRACTING WITH A HEALTH BENEFIT PLAN OR HEALTH INSURER MAY

NOT REQUIRE COST-SHARING IN AN AMOUNT OR DIRECT A PHARMACY TO

COLLECT COST-SHARING IN AN AMOUNT, GREATER THAN THE LESSER OF

EITHER OF THE FOLLOWING FROM AN INDIVIDUAL PURCHASING A

PRESCRIPTION DRUG:

(1) THE AMOUNT AN INDIVIDUAL WOULD PAY FOR THE

PRESCRIPTION DRUG IF THE PRESCRIPTION DRUG WERE TO BE

PURCHASED WITHOUT COVERAGE UNDER A HEALTH BENEFIT PLAN.

(2) THE NET REIMBURSEMENT PAID TO THE PHARMACY FOR THE

PRESCRIPTION DRUG BY THE HEALTH INSURER OR PBM.

(B) DUTY WHEN FILLING A PRESCRIPTION.--WHEN FILLING A

PRESCRIPTION, IF A PHARMACIST, PHARMACY INTERN OR TECHNICIAN

DETERMINES THAT INFORMATION INDICATING THAT THE COST-SHARING

AMOUNT REQUIRED BY THE PATIENT'S HEALTH BENEFIT PLAN EXCEEDS THE

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AMOUNT THAT MAY OTHERWISE BE CHARGED FOR THE SAME PRESCRIPTION

DRUG, BOTH OF THE FOLLOWING SHALL APPLY:

(1) THE PHARMACIST, PHARMACY INTERN OR TECHNICIAN SHALL

NOTIFY THE PATIENT.

(2) THE PATIENT MAY NOT BE CHARGED THE HIGHER AMOUNT.

SECTION 605. NETWORK ADEQUACY.

(A) GENERAL RULE.--A PBM SHALL ESTABLISH A REASONABLY

ADEQUATE AND ACCESSIBLE PBM NETWORK FOR THE PROVISION OF

PRESCRIPTION DRUGS UNDER A HEALTH BENEFIT PLAN THAT SHALL

PROVIDE FOR CONVENIENT PATIENT ACCESS TO PHARMACIES WITHIN A

REASONABLE DISTANCE FROM A PATIENT'S RESIDENCE IN ACCORDANCE

WITH THE FOLLOWING REQUIREMENTS:

(1) A MAIL-ORDER PHARMACY SHALL NOT BE INCLUDED IN THE

CALCULATIONS DETERMINING PBM NETWORK ADEQUACY.

(2) THE NETWORK MAY NOT BE LIMITED TO AFFILIATED

PHARMACIES ONLY.

(3) THE NETWORK SHALL MEET OR EXCEED THE REQUIREMENTS OF

42 CFR 423.120(A)(1) (RELATING TO ACCESS TO COVERED PART D

DRUGS) OR SUCCESSOR REGULATION.

(B) REPORT REQUIREMENT.--BEGINNING APRIL 1, 2026, AND

ANNUALLY THEREAFTER, A PBM SHALL FILE WITH THE DEPARTMENT A

NETWORK ADEQUACY REPORT DESCRIBING THE PBM NETWORK AND THE PBM

NETWORK'S ACCESSIBILITY IN THIS COMMONWEALTH ON A FORM

PRESCRIBED BY THE DEPARTMENT, WHICH SHALL BE POSTED ON THE

DEPARTMENT'S PUBLICLY ACCESSIBLE INTERNET WEBSITE.

SECTION 606. REGULATIONS.

THE DEPARTMENT MAY PROMULGATE REGULATIONS AS NECESSARY AND

APPROPRIATE TO CARRY OUT THIS CHAPTER.

SECTION 607. APPLICABILITY.

IF A CONTRACT IS IN EFFECT ON THE EFFECTIVE DATE OF THIS

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SECTION THAT CONFLICTS WITH THIS CHAPTER, THE PROVISION OF THIS

CHAPTER SHALL NOT APPLY UNTIL THE DATE THE CONTRACT IS AMENDED,

EXTENDED OR RENEWED.

SECTION 6. THE ACT IS AMENDED BY ADDING A SECTION TO READ:

SECTION 703.1. TRANSPARENCY REPORT REQUIRED.

(A) GENERAL RULE.--BEGINNING JULY 1, 2026, AND ANNUALLY

THEREAFTER, EACH LICENSED PBM SHALL SUBMIT A TRANSPARENCY REPORT

CONTAINING DATA FROM THE PRIOR CALENDAR YEAR TO THE DEPARTMENT.

THE TRANSPARENCY REPORT SHALL CONTAIN THE FOLLOWING INFORMATION:

(1) THE AGGREGATE AMOUNT OF ALL REBATES THAT THE PBM

RECEIVED FROM ALL PHARMACEUTICAL MANUFACTURERS FOR ALL HEALTH

BENEFIT PLAN AND HEALTH INSURER CLIENTS AND FOR EACH HEALTH

BENEFIT PLAN OR HEALTH INSURER CLIENT.

(2) THE AGGREGATE ADMINISTRATIVE FEES THAT THE PBM

RECEIVED FROM ALL MANUFACTURERS FOR ALL HEALTH BENEFIT PLAN

AND HEALTH INSURER CLIENTS AND FOR EACH HEALTH BENEFIT PLAN

OR HEALTH INSURER CLIENT.

(3) THE AGGREGATE RETAINED REBATES THAT THE PBM RECEIVED

FROM ALL PHARMACEUTICAL MANUFACTURERS AND DID NOT PASS

THROUGH TO HEALTH BENEFIT PLAN OR HEALTH INSURER CLIENTS.

(4) THE HIGHEST, LOWEST AND MEAN AGGREGATE RETAINED

REBATE PERCENTAGE FOR ALL HEALTH BENEFIT PLAN OR HEALTH

INSURER CLIENTS AND FOR EACH HEALTH BENEFIT PLAN OR HEALTH

INSURER CLIENT.

(5) FOR A PBM THAT CONTROLS OR IS AFFILIATED WITH A

PHARMACY, A DESCRIPTION OF ANY DIFFERENCES BETWEEN WHAT THE

PBM REIMBURSES OR CHARGES AFFILIATED AND NONAFFILIATED

PHARMACIES.

(B) PUBLICATION.--WITHIN 60 DAYS OF RECEIPT, THE DEPARTMENT

SHALL PUBLISH THE TRANSPARENCY REPORT UNDER THIS SECTION ON THE

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DEPARTMENT'S PUBLICLY ACCESSIBLE INTERNET WEBSITE IN A FORM THAT

DOES NOT DISCLOSE THE IDENTITY OF A SPECIFIC HEALTH BENEFIT PLAN

OR HEALTH INSURER, THE PRICES CHARGED FOR SPECIFIC DRUGS OR

CLASSES OF DRUGS OR THE AMOUNT OF ANY REBATES PROVIDED FOR

SPECIFIC DRUGS OR CLASSES OF DRUGS.

REGULATION, DIRECT PBMS TO INCLUDE ADDITIONAL CATEGORIES FOR

AGGREGATED DATA FROM HEALTH BENEFIT PLAN OR HEALTH INSURER

CLIENTS IN THE ANNUAL TRANSPARENCY REPORT SUBMITTED UNDER THIS

SECTION.

SECTION 7. SECTION 901 OF THE ACT IS AMENDED TO READ:

SECTION 901. SCOPE OF ENFORCEMENT AUTHORITY.

(A) SCOPE.--THE DEPARTMENT MAY INVESTIGATE AND ENFORCE THE

PROVISIONS OF THIS ACT ONLY INSOFAR AS THE ACTIONS OR INACTIONS

BEING INVESTIGATED RELATE TO PRESCRIPTION DRUG COVERAGE UNDER A

HEALTH [INSURANCE POLICY] BENEFIT PLAN.

[(B) REMEDY.--ACTIONS OR INACTIONS WITHIN THE SCOPE OF THE

DEPARTMENT'S INVESTIGATIVE AND ENFORCEMENT AUTHORITY UNDER

SUBSECTION (A) FOUND TO VIOLATE THIS ACT CONSTITUTE "UNFAIR

METHODS OF COMPETITION" AND "UNFAIR OR DECEPTIVE ACTS OR

PRACTICES" WITHIN THE MEANING OF SECTION 5 OF THE ACT OF JULY

22, 1974 (P.L.589, NO.205), KNOWN AS THE UNFAIR INSURANCE

PRACTICES ACT. A PROCEEDING UNDER THIS SECTION SHALL BE

CONDUCTED IN ACCORDANCE WITH 2 PA.C.S. CH. 5 SUBCH. A (RELATING

TO PRACTICE AND PROCEDURE OF COMMONWEALTH AGENCIES).]

(B.1) EXAMINATION AND ACCESS TO RECORDS.--

(1) THE DEPARTMENT MAY ORDER A PBM, A HEALTH INSURER AND

A PBM'S OR HEALTH INSURER'S AFFILIATES TO PRODUCE RECORDS,

BOOKS OR OTHER INFORMATION AS REASONABLY NECESSARY TO

ASCERTAIN COMPLIANCE WITH THIS ACT.

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(2) THE DEPARTMENT MAY EXAMINE OR AUDIT THE BOOKS AND

RECORDS OF A PBM, A HEALTH INSURER AND A PBM'S OR HEALTH

INSURER'S AFFILIATES TO ASCERTAIN COMPLIANCE WITH THIS ACT.

THE EXAMINATION SHALL BE CONDUCTED IN ACCORDANCE WITH ARTICLE

IX OF THE ACT OF MAY 17, 1921 (P.L.789, NO.285), KNOWN AS THE

INSURANCE DEPARTMENT ACT OF 1921.

HEARING, THAT THIS ACT HAS BEEN VIOLATED, THE COMMISSIONER MAY

IMPOSE THE FOLLOWING PENALTIES:

(1) SUSPENSION OR REVOCATION OF THE LICENSEE'S LICENSE,

AUTHORIZATION TO OPERATE OR REGISTRATION.

(2) REFUSAL TO ISSUE OR RENEW A LICENSE, AUTHORIZATION

TO OPERATE OR REGISTRATION.

(3) A CEASE AND DESIST ORDER.

(4) ORDER REIMBURSEMENT TO AN INSURED, PHARMACY OR

DISPENSER THAT HAS INCURRED A MONETARY LOSS AS A RESULT OF A

VIOLATION OF THIS ACT.

(5) FOR EACH VIOLATION OF THIS ACT THAT A LICENSEE KNEW

OR REASONABLY SHOULD HAVE KNOWN WAS A VIOLATION, A PENALTY OF

NOT MORE THAN $100,000, NOT TO EXCEED AN AGGREGATE PENALTY OF

$1,000,000 IN A SINGLE CALENDAR YEAR.

(6) FOR EACH VIOLATION OF THIS ACT THAT A LICENSEE DID

NOT KNOW NOR REASONABLY SHOULD HAVE KNOWN WAS A VIOLATION, A

PENALTY OF NOT MORE THAN $50,000, NOT TO EXCEED AN AGGREGATE

PENALTY OF $500,000 IN A SINGLE CALENDAR YEAR.

SECTION 8. THE ACT IS AMENDED BY ADDING SECTIONS TO READ:

SECTION 902. REGULATIONS.

THE DEPARTMENT MAY PROMULGATE REGULATIONS AS NECESSARY AND

APPROPRIATE TO CARRY OUT THIS CHAPTER.

SECTION 903. CONSTRUCTION.

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NOTHING IN THIS ACT SHALL BE CONSTRUED TO APPLY TO THE

CONDUCT OF A PBM IN CONNECTION WITH A CONTRACT WITH A SELF-

FUNDED GROUP HEALTH PLAN SUBJECT TO 29 U.S.C. CH. 18 (RELATING

TO EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM) . or exempted

from 29 U.S.C. Ch. 18 Subch. I (relating to protection of

employee benefit rights) by 29 U.S.C. § 1003(b) (relating to

coverage).

Section 5 9. This act shall take effect in 60 days.

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