ORS § 735.537

Current through 2024 Regular Session legislation
Section 735.537 - [Operative 1/1/2025] Reports to department regarding payments received from manufacturers and disposition of payments from manufacturers
(1) As used in this section:
(a) "Administrative fee" means the administrative and service fees charged by pharmacy benefit managers to manufacturers and carriers that are typically a percentage of the list price of a prescription drug.
(b) "Carrier" has the meaning given that term in ORS 743B.005.
(c) "Manufacturer" has the meaning given that term in ORS 646A.689.
(d) "Prescription drug" has the meaning given that term in ORS 646A.689.
(e) "Spread pricing" means the difference between the amount an insurer pays a pharmacy benefit manager and the amount that the pharmacy benefit manager reimburses a pharmacy for a beneficiary's prescription.
(2) Not later than June 1 of each calendar year, a pharmacy benefit manager licensed under ORS 735.532 shall file a report with the Department of Consumer and Business Services. The report must contain, for the immediately preceding calendar year:
(a) The aggregated dollar amount of rebates, fees, price protection payments and any other payments the pharmacy benefit manager received from manufacturers:
(A) Related to managing the pharmacy benefits for carriers issuing health benefit plans in this state; and
(B) That were:
(i) Passed on to carriers issuing health benefit plans in this state or enrollees at the point of sale of a prescription drug in this state; or
(ii) Retained as revenue by the pharmacy benefit manager.
(b) The total dispensing fees paid to the pharmacy benefit manager and to pharmacies.
(c) The total administrative fees obtained and retained from manufacturers and carriers.
(d) Moneys obtained through spread pricing, pay-for-performance or similar means.
(3) The report described in subsection (2) of this section may not disclose:
(a) The identity of a carrier or an enrollee;
(b) The price charged for a specific prescription drug or class of drugs; or
(c) The amount of any rebate or fee provided for a specific prescription drug or class of prescription drugs.
(4) Information submitted to the department under this section is confidential and not subject to disclosure except as provided in subsection (5) of this section and ORS 705.137.
(5) Not later than October 1 of each calendar year, the department shall publish on the department's website the aggregated data from all reports filed by pharmacy benefit managers under this section for the preceding calendar year. The department shall publish the data in a manner that does not disclose confidential information of pharmacy benefit managers.

ORS 735.537

Amended by 2024 Ch. 87,§ 8, eff. 4/4/2024, op. 1/1/2025.
Added by 2023 Ch. 466, § 2

See note under 735.530.

This section is set out more than once due to postponed, multiple, or conflicting amendments.