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.
This bill requires healthcare organizations participating in the federal 340B drug pricing program to submit annual reports to Idaho state agencies about their program participation and financial details. The reports must include information on drug acquisition costs, payments to contract pharmacies, savings generated, and how those savings are used for charity care or community benefits, broken down by insurance payer type. The data will be kept confidential and shared through a secure portal, with an aggregated summary made available publicly on the state website. The attorney general may use the information to investigate potential Medicaid fraud and ensure compliance with federal requirements.
This bill clarifies that Idaho chiropractors with clinical nutrition certification may prescribe specific non-controlled medications, including certain vitamins (A, B complex, C), minerals (calcium, magnesium, zinc), fluids (saline, dextrose), epinephrine, and oxygen for emergencies. It specifies these drugs must be obtained from licensed sources and administered via approved routes, while prohibiting chiropractors from compounding vitamins/minerals themselves. The law directly affects certified chiropractors in Idaho, allowing them to prescribe these items during practice without altering existing non-prescription supplement use. The bill takes effect July 1, 2026, after passing unanimously in the Idaho Senate.
S 1313 creates a voluntary licensure pathway for pharmacists in Idaho to become naturopathic doctors by requiring them to complete a 160-credit-hour naturopathic program and pass a competency exam, while maintaining their existing pharmacy license. The bill amends Idaho Code to include pharmacists in the definition of "licensed naturopathic doctor" and updates committee structures to reflect this new option, including adding a pharmacist to the formulary committee. The law will take effect on July 1, 2026.
