Vermont § 2001 - Legislative oversight

§ 2001. Legislative oversight

• (a) Notwithstanding the provisions of 2 V.S.A. § 20(d), the Commissioner of Vermont Health Access shall report annually on or before October
  30 to the House Committees on Appropriations, on Health Care, and on Human Services
  and the Senate Committees on Appropriations and on Health and Welfare concerning the
  Pharmacy Best Practices and Cost Control Program and the operation of Vermont’s pharmaceutical
  assistance programs for the most recent State fiscal year. Topics covered in the report
  shall include: (1) issues related to drug cost and utilization; (2) the effect of national trends on the pharmacy programs; (3) comparisons to other states; (4) the Department’s administration of Vermont’s pharmaceutical assistance programs; (5) the Department’s use of prior authorization requirements for prescription drugs; and (6) decisions made by the Department’s Drug Utilization Review Board in relation to both
  drug utilization review efforts and the placement of drugs on the Department’s preferred
  drug list. (b)(1) The Commissioner shall not enter into a contract with a pharmacy benefit manager unless
  the pharmacy benefit manager has agreed to disclose to the Commissioner the terms
  and the financial impact on Vermont and on Vermont beneficiaries of: (A) any agreement with a pharmaceutical manufacturer to favor the manufacturer’s products
  over a competitor’s products, or to place the manufacturer’s drug on the pharmacy
  benefit manager’s preferred list or formulary, or to switch the drug prescribed by
  the patient’s health care provider with a drug agreed to by the pharmacy benefit manager
  and the manufacturer; (B) any agreement with a pharmaceutical manufacturer to share manufacturer rebates and
  discounts with the pharmacy benefit manager, or to pay “soft money” or other economic
  benefits to the pharmacy benefit manager; (C) any agreement or practice to bill Vermont health benefit plans for prescription drugs
  at a cost higher than the pharmacy benefit manager pays the pharmacy; (D) any agreement to share revenue with a mail order or internet pharmacy company; (E) any agreement to sell prescription drug data concerning Vermont beneficiaries or data
  concerning the prescribing practices of the health care providers of Vermont beneficiaries;
  or (F) any other agreement of the pharmacy benefit manager with a pharmaceutical manufacturer,
  or with wholesale and retail pharmacies, affecting the cost of pharmacy benefits provided
  to Vermont beneficiaries. (2) The Commissioner shall not enter into a contract with a pharmacy benefit manager who
  has entered into an agreement or engaged in a practice described in subdivision (1)
  of this subsection, unless the Commissioner determines that the agreement or practice
  furthers the financial interests of Vermont and does not adversely affect the medical
  interests of Vermont beneficiaries. (Added 2001, No. 127 (Adj. Sess.), § 1, eff. June 13, 2002; amended 2005, No. 174 (Adj. Sess.), § 103; 2009, No. 33, § 83; 2009, No. 156 (Adj. Sess.), § I.64; 2011, No. 171 (Adj. Sess.), § 41c; 2015, No. 23, § 57; 2015, No. 58, § E.307.1; 2015, No. 97 (Adj. Sess.), § 68; 2015, No. 172 (Adj. Sess.), § E.306.10; 2021, No. 130 (Adj. Sess.), § 2, eff. May 24, 2022.)