Pennsylvania is the latest state to pass legislation aimed at regulating pharmacy benefit managers (PBMs) with House Bill 1993 (HB 1993), which was signed into law by Governor Shapiro on July 17, 2024. The law generally becomes effective on November 14, 2024. HB 1993 governs disclosure, reporting, and contractual requirements for PBMs doing business in Pennsylvania. It will also have some effect on insurance carriers and the administration and design of fully insured medical plans offered in the state that are subject to Pennsylvania’s insurance laws. The law expressly excludes self-insured: (i) ERISA plans, (ii) non-federal governmental entity plans, and (iii) church plans.
This Alert summarizes HB 1993, with a focus on those provisions most likely to impact employer-sponsored coverage. This Alert is relevant to employers offering fully insured prescription drug benefits to Pennsylvania residents.
