Prohibit certain health plan issuer pharmacy restrictions

hb972_00_IN

As Introduced

136th
General Assembly

Regular
Session
H. B. No. 972

2025-2026

Representative Deeter

To
enact section 3902.78 of the Revised Code
to
prohibit a health plan issuer from imposing restrictions on pharmacy
services that increase transparency and prescription drug access for
patients.

BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section
1.
That
section 3902.78 of the Revised Code be enacted to read as follows:

Sec.
3902.78.
No
health plan issuer, including a pharmacy benefit manager or other
third-party administrator, with respect to the provision of pharmacy
or pharmacist services under a health benefit plan, shall prohibit,
restrict, or impose a penalty on a pharmacy, pharmacist, or
personally furnishing prescriber, for, directly or through a third
party, offering services or products to increase transparency and
prescription drug access for patients, including any of the
following:

(A)
Simplified payment processes, electronic payments, or payment plans;

(B)
Adherence support services or communications;

(C)
Information regarding patient out-of-pocket drug costs or alternative
medication options;

(D)
Utilizing electronic transactions that allow a pharmacist or pharmacy
to provide patients with information about prescription drug costs
and benefits;

(E)
Utilizing electronic transactions that allow a pharmacist or pharmacy
to provide a patient with prior authorization support for a
prescription drug;

(F)
Sharing patient claims data or other health care transaction data
with the patient, the patient's health care provider and the
provider's business associates, or any third party authorized by the
patient, when the pharmacist or pharmacy processes the claim or other
electronic transaction, or at any time thereafter;

(G)
As permitted by state and federal law, providing prescription drug
copayment assistance or other out-of-pocket cost support to patients
for prescription drugs.