S479 - SCRIPT Act. (SL 2025-69)

Overview: S.L. 2025-69 (Senate Bill 479) does the following:

• Clarifies the pharmacy of choice provisions of Chapter 58 (Insurance) apply to pharmacy benefit managers (PBM) to the same extent that they apply to health benefit plans and allows PBMs to provide a monetary advantage to pharmacies located (i) in counties with fewer than 20,000 residents,  (ii) in urban communities without any pharmacies in a 2-mile radius, and (iii) in rural communities without any pharmacies in a 15-mile radius.
• Implements licensing for pharmacy services administrative organizations (PSAO).
• Requires PBMs to report rebate and spread pricing information to the Commissioner of Insurance.  
• Prohibits PBMs from requiring multiple specialty accreditations for specialty pharmacies.
• Makes changes to pharmacy audit procedures.
• Requires PBMs to reimburse affiliated and non-affiliated pharmacies the same rate for the same services.  
• Requires insurers to calculate out-of-pocket costs after taking into account all prescription rebates.
• Requires drug manufacturers to notify interested parties about price increases.
• Requires the Board of Pharmacy to report on the number of openings and closings of small and large pharmacies each year.
• Requires the State Health Plan (SHP) to study the economic feasibility of incorporating many of these provisions into the SHP when the third-party administrative services contract is renewed.
• Extends pharmacy benefit reimbursement rates in Medicaid managed care until June 30, 2031.

The pharmacy of choice, rebate reporting, specialty accreditation, reimbursement, and SHP provisions became effective October 1, 2025.  The drug manufacturer notice provisions become effective January 1, 2026.  The PSAO licensing provisions become effective October 1, 2026.  The out-of-pocket-cost calculation provisions become effective January 1, 2027.  The remaining provisions became effective July 9, 2025.