Bill Text: AZ HB2429 | 2025 | Fifty-seventh Legislature 1st Regular | Introduced

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Bill Title: Pharmacy benefits; pharmacy management networks

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2025-01-21 - Assigned to House RULES Committee [HB2429 Detail]

Download: Arizona-2025-HB2429-Introduced.html

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REFERENCE TITLE: pharmacy benefits; pharmacy management networks

 

 

 

 

State of Arizona

House of Representatives

Fifty-seventh Legislature

First Regular Session

2025

 

 

 

HB 2429

 

Introduced by

Representative Livingston

 

 

 

 

 

 

 

 

An Act

 

amending title 23, chapter 6, article 9, Arizona Revised Statutes, by adding section 23-1062.04; related to workers' compensation.

 

 

(TEXT OF BILL BEGINS ON NEXT PAGE)

 

Be it enacted by the Legislature of the State of Arizona:

Section 1. Title 23, chapter 6, article 9, Arizona Revised Statutes, is amended by adding section 23-1062.04, to read:

START_STATUTE23-1062.04. Pharmacy benefits; pharmacy management network; notice; registration; fee; disputes; audit; rulemaking

A. An employer may establish a pharmacy management network to provide necessary medications to injured employees.

B. A pharmacy management network may contract for reimbursement amounts that are different from the fee schedule ESTABLISHED by the Commission pursuant to section 23-908.

C. An employer that establishes a pharmacy MANAGEMENT network shall do both of the following:

1. When the employer initially establishes the pharmacy management network, notify employees regarding the PHARMACY management network and the process for filling a prescription by either posting the notice in a prominent location in the workplace or by providing the information on paper or electronic format.

2. At the time of a reported injury, notify the employee on how to use the pharmacy management network and provide a list of participating network pharmacies and providers on paper or electronic format.

D. An employee who is notified pursuant to subsection C, paragraph 2 of this section is required to obtain all outpatient medications from a pharmacy or dispensing provider that participates in the pharmacy management network.

e. Out-of-network prescriptions from retail pharmacies or dispensing PROVIDERS for medications that are medically necessary, that comply with treatment guidelines and that are related to a COMPENSABLE CLAIM SHALL be reimbursed at the fee schedule amount established by the commission pursuant to section 23-908 until the payor or pharmacy management network PROVIDES to the out-of-network pharmacy or dispensing provider a notice that contains all of the following:

1. Notice that the injured worker is required to receive prescriptions from a pharmacy or dispensing provider that participates in the established pharmacy management network.

2. Notice that future medication refills by the out-of-network pharmacy or dispensing provider will not be REIMBURSED.

3. An invitation to the pharmacy or dispensing provider to join the pharmacy management network, if desired.

F. A pharmacy management network shall accept as part of the pharmacy management network any pharmacy or dispensing provider that is licensed and in good standing and willing to abide by the pharmacy management network's contract terms.

G. A pharmacy management network shall register with the Commission and submit a form as prescribed by the commission.  A pharmacy management network shall pay a registration fee in an amount established by the Commission.

H. A pharmacy management network shall provide a timely process for PHARMACIES and dispensing providers to dispute a reimbursement of a pharmacy bill.

I. A pharmacy MANAGEMENT network or a contracted pharmacy management network shall perform any audits of pharmacies or dispensing providers in ACCORDANCE with the audit provisions pursuant to section 20-3322.

J. A pharmacy management network or a contracted pharmacy management network may not charge pharmacies or dispensing providers for any direct or indirect fees associated with dispensing, processing or billing of a prescription drug or medication that is dispensed to an injured employee.

K. A pharmacy processing agent or third-party biller that accepts the assignment of bills from a pharmacy or dispensing provider that is contracted with a pharmacy management network must be reimbursed at the contractual amount agreed to by the assigning pharmacy or dispensing provider.

L. iF A CLAIM IS DISPUTED FOR COMPENSABILITY, An injured employee is not required to use a pharmacy or dispensing provider in the pharmacy management network UNTIL THE CLAIM DISPUTE IS RESOLVED AND THE pharmacy management network provides notice to the parties.

M. a Pharmacy management network THAT IS registered with this state and providES pharmacy services under this SECTION IS exempt from title 20, chapter 25, article 2.

N. The commission may adopt rules necessary to implement the requirements of this section. END_STATUTE

Sec. 2. Effective date

Section 23-1062.04, Arizona Revised Statutes, as added by this act, is effective from and after December 31, 2025.