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2026 Session

Budget Amendments - HB30 (Member Request)

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Chief Patron: Hodges
Pharmacy Benefit Managers (language only)

Item 478 #2h

Item 478 #2h

Independent Agencies
State Corporation Commission

Language

Page 550, after line 33, insert:

"F. Upon request by a purchaser, Pharmacy Benefit Managers (PBMs) will provide to the purchaser aggregate pharmacy claims level data that was paid by the PMB to the contracted pharmacies on a quarterly basis and at least 90 days prior to the renewal date. Purchasers are to include the Employee Retirement Income Security Act (ERISA) and Commonwealth of Virginia (COVA) health plans."



Explanation

(This amendment sets forth additional requirements for Pharmacy Benefit Managers with respect to the provision of purchaser aggregate pharmacy claims level data. Upon enrolling, additional amendments will be added to the extent this language impacts other health benefit programs. This is a placeholder amendment until all impacts are known.)