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SECOND REGULAR SESSION
SENATE BILL NO. 1340
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR TRENT.
5573S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section relating to payments for
prescription drugs.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto 1
one new section, to be known as section 376.417, to read as 2
follows:3
376.417. 1. As used in this section, the following 1
terms mean: 2
(1) "340B drug", the same meaning given to the term in 3
section 376.414; 4
(2) "Covered entity", any entity described in 5
subparagraphs (A) to (K) of subsection (a)(4) of Section 6
340B of the Public Health Service Act, 42 U.S.C. Section 7
256b, including any pharmacy with which such entity has 8
contracted to dispense 340B drugs on behalf of the entity; 9
(3) "Health carrier", the same meaning given to the 10
term in section 376.1350; 11
(4) "Pharmacy", an entity licensed under chapter 338; 12
(5) "Pharmacy benefits manager", the same meaning 13
given to the term in section 376.388. 14
2. A health carrier, a pharmacy benefits manager, or 15
an agent or affiliate of such health carrier or pharmacy 16
benefits manager shall not discriminate against a covered 17
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entity including, but not limited to, by doing any of the 18
following: 19
(1) Reimbursing a covered entity for a quantity of a 20
340B drug in an amount less than it would pay any other 21
similarly situated pharmacy or entity that is not a covered 22
entity for such quantity of such drug on the basis that the 23
covered entity is a covered entity or that the covered 24
entity dispenses 340B drugs. The director of the department 25
of commerce and insurance shall specify by rule the 26
circumstances under which a pharmacy or entity shall be 27
deemed a "similarly situated pharmacy or entity" for 28
purposes of this subdivision; 29
(2) Imposing any terms or conditions on covered 30
entities that differ from such terms or conditions applied 31
to other similarly situated entities or pharmacies that are 32
not covered entities on the basis that the covered entity is 33
a covered entity or that the covered entity dispenses 340B 34
drugs including, but not limited to, terms or conditions 35
with respect to any of the following: 36
(a) Fees, chargebacks, clawbacks, adjustments, or 37
other assessments; 38
(b) Professional dispensing fees; 39
(c) Restrictions or requirements regarding 40
participation in standard or preferred pharmacy networks; 41
(d) Requirements relating to the frequency or scope of 42
audits or to inventory management systems using generally 43
accepted accounting principles; and 44
(e) Any other restrictions, conditions, practices, or 45
policies that, as specified by the director of the 46
department of commerce and insurance, interfere with the 47
ability of a covered entity to maximize the value of 48
discounts provided under 42 U.S.C. Section 256b; 49
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(3) Discriminating in reimbursement to a covered 50
entity based on the determination or indication a drug is a 51
340B drug; 52
(4) Requiring a covered entity to identify, either 53
directly or through a third party, a 340B drug; 54
(5) Refusing to cover drugs purchased under the 340B 55
drug-pricing program; or 56
(6) Requiring a covered entity to reverse, resubmit, 57
or clarify a 340B drug-pricing claim after the initial 58
adjudication unless these actions are: 59
(a) In the normal course of pharmacy business and not 60
related to 340B drug pricing; or 61
(b) Required by federal law. 62
3. The director of the department of commerce and 63
insurance shall impose a civil penalty on any health 64
carrier, pharmacy benefits manager, or agent or affiliate of 65
such health carrier or pharmacy benefits manager that 66
violates the requirements of this section. Such penalty 67
shall not exceed five thousand dollars per violation per day. 68
4. The director of the department of commerce and 69
insurance shall promulgate rules to implement the provisions 70
of this section. Any rule or portion of a rule, as that 71
term is defined in section 536.010, that is created under 72
the authority delegated in this section shall become 73
effective only if it complies with and is subject to all of 74
the provisions of chapter 536 and, if applicable, section 75
536.028. This section and chapter 536 are nonseverable and 76
if any of the powers vested with the general assembly 77
pursuant to chapter 536 to review, to delay the effective 78
date, or to disapprove and annul a rule are subsequently 79
held unconstitutional, then the grant of rulemaking 80
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authority and any rule proposed or adopted after August 28, 81
2026, shall be invalid and void. 82
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