PHARMACY BENEFIT MANAGERS – Amends and adds to existing law to establish provisions regarding dispensing fees and to establish duties and restrictions pertaining to pharmacy benefit managers and third-party payers.

This bill establishes minimum reimbursement rates for independent pharmacies in Idaho by requiring plan sponsors, pharmacy benefit managers, and third-party payers to pay at least the national average drug acquisition cost plus a minimum professional dispensing fee of $12.35, which will increase annually based on inflation. The law defines key terms related to pharmacy reimbursement and mandates that pharmacy benefit managers register with the Idaho Department of Insurance and prohibits certain pricing practices like spread pricing. Additionally, the bill requires the state insurance department to issue guidance to payers and mandates that any underpayments to pharmacies be corrected retroactively from the effective date of the law.