[RSA 402-N:6 effective until Jan. 1, 2027; see also RSA 402-N:6 set out below.]
402-N:6 Pharmacy Benefits Manager Reporting. –
I. Each pharmacy benefits manager shall submit an annual or quarterly report to the commissioner containing a list of health benefit plans it administered and the rebates it collected from pharmaceutical manufacturers that were attributable to patient utilization in the state of New Hampshire during the prior calendar year. This paragraph shall not apply to Medicaid, the Medicaid Care Management Program, the Ryan White HIV/AIDS Program administered by the department of health and human services, or self-funded plans such as the state employee health benefit plan. The report submitted to the commissioner shall include the following information:
(a) The aggregate number of rebates and total value received by the pharmacy benefit manager;
(b) The aggregate number of rebates and total value distributed to the appropriate health care insurer;
(c) The aggregate number of rebates and total value passed on to an insured of each health care insurer at the point of sale that reduced the insured's applicable deductible, copayment, coinsurance, or other cost-sharing amount;
(d) The individual and aggregate amount paid by the health care insurer to the pharmacy benefit manager for pharmacist services itemized by pharmacy, by product (at the unique NDC level), and by goods and services; and
(e) The individual and aggregate amount a pharmacy benefit manager paid for pharmacist services itemized by pharmacy, by product, and by goods and services.
II. Information reported to the commissioner pursuant to this section shall be confidential and protected from disclosure under the commissioner's examination authority and shall not be considered a public record subject to disclosure under RSA 91-A. Based on this reporting, the commissioner shall make public aggregated data on the overall amount of rebates collected on behalf of covered persons in the state, but shall not release data that identifies a specific insurer or pharmacy benefit manager.
[RSA 402-N:6 effective Jan. 1, 2027; see also RSA 402-N:6 above.]
402-N:6 Pharmacy Benefits Manager Reporting. –
I. Each pharmacy benefits manager shall submit to the commissioner annually a report containing a list of health benefit plans it administered and the rebates it collected from pharmaceutical manufacturers that were attributable to patient utilization in the state of New Hampshire during the prior calendar year. The report submitted to the commissioner shall include the following information:
(a) The aggregate dollar amount spent on drugs prior to rebates;
(b) The aggregate dollar amount of all rebates that pharmacy benefit manager received from all pharmaceutical manufacturers;
(c) The aggregate dollar amount of all administrative fees that the pharmacy benefit manager received;
(d) The aggregate dollar amount of all health carrier administrative service fees that the pharmacy benefit manager received;
(e) The aggregate dollar amount of all rebates that the pharmacy benefit manager received from all pharmaceutical manufacturers and did not pass through to health plans or health carriers;
(f) The aggregate dollar amount of all administrative fees that the pharmacy benefit manager received from all pharmaceutical manufacturers and did not pass through to health plans or health carriers;
(g) The aggregate retained rebate percentage; and
(h) Across all of the pharmacy benefit manager's contractual or other relationships with all health plans or health carriers, the highest aggregate retained rebate percentage, the lowest aggregate retained rebate percentage, and the mean aggregate retained rebate percentage.
II. Information reported to the commissioner pursuant to this section shall be confidential and protected from disclosure under the commissioner's examination authority and shall not be considered a public record subject to disclosure under RSA 91-A. Based on this reporting, the commissioner shall make public aggregated data on the overall amount of rebates collected on behalf of covered persons in the state, but shall not release data that identifies a specific health carrier or pharmacy benefit manager.
III. The commissioner shall prescribe the format of the report and procedure for filing the report. Any forms, templates, or guidance regarding the report required by the section shall be exempt from the requirements of RSA 541-A.
IV. This section shall not apply to data related to Medicaid, the Medicaid Care Management program, the Ryan White HIV/AIDS program administered by the department of health and human services, self-funded plans, the state employee health benefit plan, or any other plan outside the jurisdiction of the commissioner.