Division Of Insurance Annual Report Pharmaceutical Costs Data

By March 31, 2018, and by each March 31 thereafter through March 31, 2020, the bill requires health insurers to submit to the commissioner of insurance (commissioner) information regarding pharmaceuticals covered under individual and group health insurance plans in prior years. Carriers are to report the following information, separately stated with regard to individual and group market segments:

• The total pharmaceutical costs, including cost-sharing amounts paid by insured persons, and the aggregate net pharmaceuticals costs, after negotiated rebates and discounts;
• The net cost of pharmaceuticals, expressed as a percentage of total medical costs; and
• A list of the drug classes of the 10 pharmaceuticals that were most dispensed and had the highest gross spending.

The bill also requires carriers providing or administering state group benefit plans for state employees to report the pharmaceutical cost data.

The commissioner is directed to aggregate and analyze the data and submit an annual report to the governor and specified legislative committees on trends in pharmaceutical drug costs in the insurance market, including most-prescribed and highest-cost pharmaceuticals.

The commissioner is authorized to adopt rules as necessary to implement the requirements of the bill. The reporting requirements are repealed on January 31, 2021.

(Note: This summary applies to the reengrossed version of this bill as introduced in the second house.)