Nevada lawmakers have unanimously passed and sent to the state’s governor legislation prohibiting pharmacy benefit managers and health insurance carriers from discriminating against 340B covered entities and their contract pharmacies.
The state Assembly voted 42-0 on June 3 and the state Senate 21-0 on June 5 to pass AB 434. While it is unknown if Gov. Joe Lombardo (R) will sign it, all Republicans in both Democratic-controlled chambers voted for it—a clear sign it has strong GOP support. Lombardo had not yet acted on AB 434 as of this morning.
The Nevada Primary Care Association lobbied for bill’s passage. “340B benefits are at risk in Nevada as insurers and pharmacy benefit managers seek to reimburse at lower rates for 340B drugs,” an NVPCA advocacy document said. “As these discriminatory contracts increase, safety net providers are losing access to a critical revenue stream that supports their operations and patient care.”
NVPCA said the bill will:
- set a floor for 340B reimbursement at National Drug Wholesale Acquisition Cost
- forbid PBMs and insurers from charging 340B entities additional fees, clawbacks, or adjustments that reduce entities’ 340B savings or revenue
- ensure that the right to dispense or deliver 340B prescriptions is protected, including in contract pharmacies
- prohibit insurers or PBMs from steering patients away from a 340B pharmacy
- establish in statute that Ryan White providers, not the state, are entitled to claim the 340B discount on drugs provided to Nevada Medicaid beneficiaries.
If Governor Lombardo signs AB 434, the new law will take effect Jan. 1, 2024.
About two dozen states have passed similar laws since 2019.