This text of Iowa § 510B.8B (Pharmacy benefits managers — reimbursements) is published on Counsel Stack Legal Research, covering Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
1.A pharmacy benefits manager shall not reimburse any pharmacy located in the state in
an amount less than the amount that the pharmacy benefits manager reimburses a pharmacy
benefits manager affiliate for dispensing the same prescription drug as dispensed by the
pharmacy.
2.A pharmacy benefits manager shall not reimburse any retail pharmacy located in the
state in an amount less than the most recently published national average drug acquisition
cost for a prescription drug on the date that the prescription drug is administered or
dispensed. If the most recently published national average drug acquisition cost for the
prescription drug is unavailable on the date that the prescription drug is administered or
dispensed, a pharmacy benefits manager shall not reimburse any retail pharmacy lo
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1. A pharmacy benefits manager shall not reimburse any pharmacy located in the state in
an amount less than the amount that the pharmacy benefits manager reimburses a pharmacy
benefits manager affiliate for dispensing the same prescription drug as dispensed by the
pharmacy.
2. A pharmacy benefits manager shall not reimburse any retail pharmacy located in the
state in an amount less than the most recently published national average drug acquisition
cost for a prescription drug on the date that the prescription drug is administered or
dispensed. If the most recently published national average drug acquisition cost for the
prescription drug is unavailable on the date that the prescription drug is administered or
dispensed, a pharmacy benefits manager shall not reimburse any retail pharmacy located in
the state in an amount less than the wholesale acquisition cost for the prescription drug on
the date that the prescription drug is administered or dispensed.
3. In addition to the reimbursement required under subsection 2, a pharmacy benefits
manager shall reimburse the retail pharmacy or pharmacist a professional dispensing fee in
the amount of ten dollars and sixty-eight cents.
7 REGULATION OF PHARMACY BENEFITS MANAGERS, §510B.8E
4. a. Apharmacybenefitsmanagershallsubmitaquarterlyreporttothecommissionerof
all drugs reimbursed at ten percent or more below the national average drug acquisition cost,
and all drugs reimbursed at ten percent or more above the national average drug acquisition
cost, for each prescription drug appearing on the national average drug acquisition cost list
on the day the prescription drug was dispensed.
b. For each prescription drug included in the report, a pharmacy benefits manager shall
include all of the following information:
(1) The month the prescription drug was dispensed.
(2) The quantity of the prescription drug dispensed.
(3) The amount the pharmacy was reimbursed.
(4) If the dispensing pharmacy was an affiliate of the pharmacy benefits manager.
(5) If the prescription drug was dispensed pursuant to a government health plan.
(6) The average national drug acquisition cost for the month the prescription drug was
dispensed.
c. The report shall exclude drugs dispensed pursuant to 42 U.S.C. §256b.
d. A copy of the report shall be published on the pharmacy benefits manager’s public
internet site for twenty-four months after the date the report is submitted to the commission.
5. This section shall not apply to a pharmacy that operates in a state-owned facility.