A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions.

Changed the document format from line-by-line amendment markup to standard enacted bill format with proper section numbering and page references.

Added new definitions for 'National average drug acquisition cost', 'Pass-through pricing', 'Pharmacy chain', 'Retail pharmacy', 'Specialty drug', and 'Wholesale acquisition cost'.

Added new requirements prohibiting pharmacy benefits managers from discriminating against pharmacies or pharmacists, limiting their ability to designate drugs as specialty drugs, and requiring specific reimbursement amounts.

Added provisions allowing the commissioner to deny certification of pharmacy benefits managers that do not comply with the new requirements.

Removed the Governor's signature message, date, and handwritten notes that were part of the marked-up version

Added standard bill header information including committee name, amendment dates, and page numbers

Reformatted text layout and removed handwritten markup symbols like strikethroughs and insertion markers

Removed Governor's signature block and message text, converting to standard enrolled bill format with page numbers and section headers.

Adjusted section numbering and formatting to match official enrolled bill standards.

Corrected minor formatting inconsistencies in subsection labels and spacing throughout the document.

Added new definitions for 'National average drug acquisition cost,' 'Pass-through pricing,' 'Pharmacy chain,' 'Retail pharmacy,' 'Specialty drug,' 'Spread pricing,' and 'Wholesale acquisition cost' to clarify regulatory standards.

Added new prohibited conduct provisions requiring PBMs to allow patients to choose their pharmacies, prohibiting discrimination against pharmacies, and banning unreasonable specialty drug designations.

Added reimbursement requirements mandating that PBMs reimburse pharmacies at least the same amount they pay PBM affiliates, and requiring reimbursement based on national average drug acquisition cost or wholesale acquisition cost.

Added requirements for PBMs to submit quarterly reports on drugs reimbursed at or below national average drug acquisition cost thresholds.

Modified enforcement provisions to allow covered persons or pharmacies to file complaints with the commissioner and maintain causes of action to enjoin violations.