Section 4533.1 - PBM transparency report required.(a)General rule.--Beginning July 1, 2026, and annually thereafter, each registered PBM shall submit to the department a transparency report containing data for each health insurer client in this Commonwealth from the prior calendar year. The transparency report shall contain the following information: (1) The aggregate amount of all rebates that the PBM received from all pharmaceutical manufacturers for all health insurer clients and for each health insurer client.(2) The aggregate administrative fees that the PBM received from all manufacturers for all health insurer clients and for each health insurer client.(3) The aggregate-retained rebates that the PBM received from all pharmaceutical manufacturers and did not pass through to health insurer clients.(4) The highest, lowest and mean aggregate retained rebate percentage for all health insurer clients and for each health insurer client.(5) For a PBM that controls or is affiliated with a pharmacy, a description of any differences between what the PBM reimburses or charges affiliated and nonaffiliated pharmacies.(b) Publication.--Within 60 days of receipt, the department shall publish the transparency report under this section on the department's publicly accessible Internet website in a form that meets the following requirements:(1) Does not disclose the name of a PBM.(2) Does not directly or indirectly disclose the identity of a specific health insurer client or present information in a manner that can be extrapolated to identify a specific health insurer client.(3) Does not list the price or prices charged for a specific drug or class of drugs.(4) Does not specify the amount of any rebates provided for a specific drug or class of drug.(c) Additional categories.--The department may, by regulation, direct PBMs to include additional categories for aggregated data from health insurer clients in the annual transparency report submitted under this section.(d)Confidentiality.-- (1) The information submitted to the department in accordance with the transparency report required under subsection (a) shall be privileged and given confidential treatment and shall not be: (i) Subject to discovery or admissible as evidence in a private civil action;(ii) Subject to subpoena;(iii) Subject to access under the act of February 14, 2008 (P.L.6, No.3), known as the Right-To-Know Law; or(iv) Made public by the department or any other person without the prior written consent of the PBM, insurer or insurance group to which it pertains, except as provided in paragraph (3).(2) The commissioner, the department, a person who receives information under subsection (a) while acting under the authority of the commissioner or department or a person with whom the information is shared under this chapter shall not be permitted or required to testify in a private civil action concerning confidential information in the transparency report.(3) To assist in the performance of its regulatory duties, the department may:(i) Use information submitted under this section in furtherance of a regulatory or legal action brought pursuant to the department's official duties.(ii) Share information submitted under this section with the NAIC, regulatory or law enforcement officials of this Commonwealth or other jurisdictions, and third-party consultants, if, prior to receiving the transparency report information, the recipient demonstrates by written statement the necessary authority and intent to give confidential treatment to the information as required by this section.(iii) Publish all or part of the information if, after giving the entity who would be affected thereby notice and opportunity to be heard, the department determines that the interest of the public will be served by the publication thereof.(4) The sharing of information by the department under this section does not constitute a delegation of regulatory authority or rulemaking. The department shall be solely responsible for the administration, execution and enforcement of this chapter.(5) The sharing of transparency report information with, to or by the department as authorized by this chapter does not constitute a waiver of any applicable privilege or claim of confidentiality.(6) Information submitted under this section that is in the possession or control of the NAIC or a third-party consultant as provided under this section shall:(i) Be confidential and privileged;(ii) Be exempt from access under the right-to-know law;(iii) Not be subject to subpoena; and(iv) Not be subject to discovery or admissible as evidence in a private civil action.Added by P.L. (number not assigned at time of publication) 2024 No. 77,§ 7, eff. 11/14/2024.