Utah lawmakers have passed and sent to the governor a bill that would forbid insurers or their PBMs from forcing federally qualified health centers to include modifiers on claims identifying drugs as being 340B purchased, Medicaid claims excepted.

Utah Might Soon Outflank Express Scripts’ New 340B Requirement

Pharmacy benefits manager Express Scripts’ (ESI) new pharmacy reporting requirement for reclassifying a previously submitted prescription drug claim as 340B-eligible “applies to the extent not prohibited by law,” the PBM says in an FAQ on its website.

ESI’s statement in the FAQ raises the possibility that states or Congress could pass laws that shield 340B covered entities from rules like ESI’s, which took effect March 1.

Pharmacy benefits manager Express Scripts’ (ESI) new pharmacy reporting requirement for reclassifying a previously submitted prescription drug claim as 340B-eligible “applies to the extent not prohibited by law,” the PBM says in an FAQ on its website. Utah is on the verge of enacting such a law.

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