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PBM Model Bills, State PBM Laws and PBM Resources
Pharmacy Benefit Managers, often known simply as “PBMs,” are largely unrecognized by most employees—and even by many benefits managers. But they have a tremendous impact on U.S. health care decision-making because they influence more than 80 percent of drug coverage. The information below is intended to provide a record of NCPA’s efforts regarding PBMs as well as any bills that have been introduced or any laws that have been passed on a state level regarding their practices.
NCPA Model Legislation:
NCPA has prepared model legislation as a regulatory framework for states to consider when addressing PBM business practices. The model language provides standards and criteria for the regulation, solvency and licensing of PBMs. Those standards include transparency, substitution criteria, fiduciary requirements and contract provisions.
The information below includes copies of certain state PBM laws and an overview of state laws that regulate the business practices of PBMs.
This section is intended to provide background information regarding PBMs.
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