AMENDMENT FOR PRINTED BILL
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___________________ moved that HB 1137 be amended as follows:
On the printed bill, delete everything after the enacting clause and insert:
" Section 1. That chapter 58-29E be amended by adding a NEW SECTION to read:
No pharmacy benefit manager shall contractually require a pharmacy, who is a participating
provider in a health plan provided by a covered entity, to charge or collect from an insured a cost
share for a prescription or pharmacy service that exceeds the amount retained by the pharmacist or
pharmacy from all payment sources for the filling of the prescription or providing the pharmacy
service.
Section 2. That chapter 58-29E be amended by adding a NEW SECTION to read:
No pharmacy benefit manager contracting with a covered entity shall retroactively adjust a claim
for reimbursement submitted by a pharmacy for a prescription drug unless the adjustment is a result
of either of the following:
(1) A pharmacy audit conducted in accordance with chapter 58-29F; or
(2) A technical billing error.
Section 3.That chapter 58-29E be amended by adding a NEW SECTION to read:
Nothing in this Act shall prohibit a pharmacy benefit manager from adjusting claim payment for
the benefit of a covered individual if there was an error in the adjudication of a claim submitted by
or on behalf of the covered individual."