Revises provisions governing the administration of pharmacy benefits under Medicaid. (BDR 38-224)

SB 149 creates a single "state pharmacy benefit manager" (SPBM) to administer all Medicaid prescription drug coverage in Nevada, replacing the current system where multiple pharmacy benefit managers (PBMs) or health plans manage these benefits separately. It requires the Department of Health and Human Services to contract exclusively with one SPBM, mandates Medicaid managed care organizations to use this SPBM for all pharmacy benefits, and sets strict rules for SPBM contracts, including prohibitions on conflicts of interest and requirements for fair reimbursement to pharmacies. The bill also establishes detailed application standards for potential SPBMs, including disclosures about ownership ties to pharmacies or health insurers, and mandates non-discriminatory reimbursement rates for all pharmacies, including those owned by healthcare facilities. These changes aim to streamline administration, ensure consistent pharmacy payments, and align with federal Medicaid requirements.