Topic: State Legislative Developments

New California Legislation Governing Health Plans’ Relationships with Pharmacies and Pharmacy Benefit Managers

Last month, California Governor Jerry Brown signed AB 315 into law. AB 315 is California’s version of the growing national trend to regulate pharmacy benefit managers (“PBMs”). PBMs are entities that not only manage prescription drug benefits under health insurance plans, including drug utilization review, drug plan formulary development, selecting pharmacies for prescription drug networks, and determining reimbursements for those pharmacies, but also operate mail order and specialty pharmacies themselves.

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Maryland Obtains Waiver for Health Reinsurance Program

Maryland officials will formally announce Wednesday that the federal government has approved an ACA state innovation waiver intended to help shore up Maryland’s individual health insurance market, which has suffered from skyrocketing premiums and declining participation by healthier persons following the repeal of the ACA’s individual mandate

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Hit the Rhode (Island) Jack

The Rhode Island state legislature has amended the enabling act to the state’s legacy transfer program, R.I.G.L § 27-14.5-1 et seq. (“R.I. Restructuring Act”), to provide clarification to the marketplace. The enabling act, originally enacted in 2002, was designed to allow for “commutation plans” to provide for reorganization through a court-approved commutation among a reinsurer or insurer and all of its insurance or reinsurance creditors.

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