Preserving Access to Rural Independent Pharmacies

The bill prevents a pharmacy benefit manager (PBM) from prohibiting a rural independent pharmacy from using a private courier or a delivery service to deliver a prescription drug to a patient.

A PBM is required to reimburse a rural independent pharmacy for a prescription drug in an amount not less than the average acquisition cost for like prescription drugs, as determined by the medical services board in the state department of health care policy and financing national average drug acquisition cost for the dispensed prescription drug ingredients , plus pay a dispensing fee.

When a PBM conducts an audit of a rural independent pharmacy and the audit results in a recoupment of more than $1,000 or a penalty of more than $1,000, the PBM must: serve process on the rural independent pharmacy and notify the rural independent pharmacy of the rural independent pharmacy's appeal rights at least 30 days before any recoupment of funds.

• Electronically notify the rural independent pharmacy of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds;
• If the rural independent pharmacy does not respond to the electronic notification within 30 days after the electronic notification, again electronically notify the rural independent pharmacy of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds; and
• If the rural independent pharmacy does not respond to the second electronic notification within 30 days after the second electronic notification, serve process on the rural independent pharmacy notifying of the rural independent pharmacy's rights to appeal at least 30 days before the recoupment of funds.

The bill defines "flex pharmacy" as a prescription drug outlet that:

• Is registered with the state board of pharmacy (board) as a prescription drug outlet;
• Operates as a telepharmacy during times when the licensed pharmacist is not on the premises;
• Has a licensed pharmacist on the premises for at least twice the number of hours that the flex pharmacy operates as a telepharmacy;
• Operates as a telepharmacy from the same premises as the premises where the pharmacy is registered; and
• Is a rural independent pharmacy.

The board may adopt rules to facilitate the operation of flex pharmacies and may assess a fee on a prescription drug outlet applying to be a flex pharmacy. Under current law, a pharmacy must be under the direct charge of a pharmacist. The bill allows a rural independent pharmacy to operate without being under the direct charge of a pharmacist if the initial interpretation and final evaluation of the prescription is done by a pharmacist in person or remotely.

(Note: Italicized words indicate new material added to the original summary; dashes through words indicate deletions from the original summary.)

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)