S257 - Medication Cost Transparency Act. (SL 2021-161)

Overview: S.L. 2021-161 requires pharmacy benefits managers (PBMs) to be licensed. It adds to the consumer protections in G.S. 58-56A-3, restricts PBMs from prohibiting pharmacies from taking certain actions, and establishes rules for claim overpayments and PBM networks. PBMs and health benefit plans are required to provide coverage for biosimilars and credit all amounts paid on behalf of insureds toward cost-sharing requirements for certain drugs. The act also increases the Commissioner's ability to take enforcement action against PBMs and creates a workgroup to study a single unified process to accredit specialty pharmacies.

The act became effective October 1, 2021, and applies to contracts entered into, renewed, or amended on or after that date.