PRINTER'S NO. 148
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
62
Session of
2023
INTRODUCED BY HUGHES, HAYWOOD, FONTANA, SCHWANK, DILLON, STREET,
COSTA, BREWSTER AND TARTAGLIONE, JANUARY 30, 2023
REFERRED TO BANKING AND INSURANCE, JANUARY 30, 2023
AN ACT
Amending the act of September 27, 1961 (P.L.1700, No.699),
entitled "An act relating to the regulation of the practice
of pharmacy, including the sales, use and distribution of
drugs and devices at retail; and amending, revising,
consolidating and repealing certain laws relating thereto,"
providing for price disclosure.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of September 27, 1961 (P.L.1700, No.699),
known as the Pharmacy Act, is amended by adding a section to
read:
Section 9.6. Price Disclosure.--(a) For every prescription
medicine that a consumer intends to purchase, a pharmacist or an
authorized employe of the pharmacist shall disclose all of the
following information:
(1) The current pharmacy retail price.
(2) The consumer's cost-sharing amount, including a
statement as to whether the cost-sharing amount is higher or
lower than the current pharmacy retail price.
(3) The median cost-sharing amount, including a statement
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
that includes the following additional information:
(i) Whether the median cost-sharing amount is higher or
lower than the current pharmacy retail price.
(ii) Information as to how and where the consumer can
purchase an on-exchange health insurance policy that includes
the median cost-sharing amount or provides comparable coverage.
(b) The board shall adopt rules and regulations necessary to
carry out and enforce this section, which shall include the
methods of determining the pharmacy retail price, cost-sharing
amount and median cost-sharing amount for prescription
medications.
(c) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
the context clearly indicates otherwise:
(1) "Cost-sharing amount" means the amount owed by a
policyholder under the terms of the policyholder's health
insurance policy or as required by a pharmacy benefit manager.
(2) "Health insurance policy" has the same meaning as
defined under section 631.1(f) of the act of May 17, 1921
(P.L.682, No.284), known as "The Insurance Company Law of 1921."
(3) "Median cost-sharing amount" means the median cost-
sharing amount for a prescription medicine, determined by
sorting the cost-sharing amounts for the prescription medication
for all on-exchange health insurance policies in the county
where a pharmacy is located and selecting the middle value. The
board shall collaborate with the Department of Insurance in
determining which on-exchange health insurance policies should
be included in calculating the median cost-sharing amount for a
prescription medication.
(4) "On-exchange health insurance policy" means a health
20230SB0062PN0148 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
insurance policy offered for purchase on the official State-
based health insurance marketplace of the Commonwealth.
(5) "Pharmacy benefit manager" has the same meaning as
defined under section 449(l) of the act of June 13, 1967
(P.L.31, No.21), known as the "Human Services Code."
(6) "Pharmacy retail price" means the price that an
individual without prescription drug coverage or not using any
other prescription medication benefit or discount would pay at a
retail pharmacy, not including a pharmacist dispensing fee.
Section 2. This act shall take effect in 60 days.
20230SB0062PN0148 - 3 -
1
2
3
4
5
6
7
8
9
10