,,ii ,cal5d> ,no4 #fdg #aag? ,,congress 
#b;d ,session  ,s4 #dbic  ,,9 ,,!       
,,s5ate ,,( ,,! ,,unit$ ,,/ates  ,may   
#bd1 #bjbb,ms4 ,cantwell 7= h]self1 ,mr4
 ,grassley1 ,mr4 ,boozman1 ,mr4 ,braun1 
,mr4 ,moran1 ,mr4 ,tillis1 ,mr4 ,te/]1  
,mrs4 ,hyde-,smi?1 & ,mrs4 ,capito7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,comm]ce1 ,sci5ce1 & ,transportation    
,decemb] #ad1 #bjbb,report$ by ,ms4     
,cantwell1 ) an amendment,strike out all
 aft] ! enact+ clause & ins]t ! "p pr9t$
 9 italic  ,a ,,bill  ,to prev5t unfair 
& deceptive acts or practices & !       
dissem9ation ( false in=mation relat$ to
 ph>macy b5efit managem5t s]vices =     
prescription drugs1 & = o!r purposes4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,ph>macy ,b5efit ,manag] ,transp>5cy  
,act ( #bjbb4  #b4 ,prohibition on      
unfair or deceptive prescription drug   
pric+ practices  7a7 ,conduct prohibit$ 
,except z provid$ 9 subsection 7b71 x   
%all be unlawful = any ph>macy b5efit   

manag] 7or affiliate1 subsidi>y1 or ag5t
 ( a ph>macy b5efit manag]71 directly or
 indirectly1 to engage 9 any ( ! foll[+ 
activities relat$ to ph>macy b5efit     
managem5t s]vices3 7#a7 ,*>ge a heal?   
plan or pay] a diff]5t am\nt = a        
prescription drug's +r$i5t co/ or       
disp5s+ fee ?an ! am\nt ! ph>macy b5efit
 manag] reimburses a ph>macy = !        
prescription drug's +r$i5t co/ or       
disp5s+ fee :]e ! ph>macy b5efit manag] 
reta9s ! am\nt ( any su* diff]5ce4  7#b7
 ,arbitr>ily1 unfairly1 or deceptively1 
by contract or any o!r means1 r$uce1    
resc9d1 or o!rwise claw back any        
reimbursem5t paym5t1 9 :ole or 9 "p1 to 
a ph>maci/ or ph>macy = a prescription  
drug's +r$i5t co/ or disp5s+ fee4  7#c7 
,arbitr>ily1 unfairly1 or deceptively1  
by contract or any o!r means1 increase  
fees or l[] reimbursem5t to a ph>macy 9 
ord] to (fset reimbursem5t *anges       
in/ruct$ by ! ,f$]al ,gov]nm5t "u any   
heal? plan fund$ by ! ,f$]al ,gov]nm5t4 
7b7 ,exceptions ,a ph>macy b5efit manag]

 %all n be 9 violation ( subsection 7a7 
if ! ph>macy b5efit manag] meets !      
foll[+ conditions3 7#a7 ,! ph>macy      
b5efit manag]1 affiliate1 subsidi>y1 or 
ag5t passes along or returns #ajj p]c5t 
( any price concession to a heal? plan  
or pay]1 includ+ any rebate1 disc\nt1 or
 o!r price concession4  7#b7 ,! ph>macy 
b5efit manag]1 affiliate1 subsidi>y1 or 
ag5t provides full & complete disclosure
 (-- 7,a7 ! co/1 price1 & reimbursem5t (
 ! prescription drug to ea* heal? plan1 
pay]1 & ph>macy ) :i* ! ph>macy b5efit  
manag]1 affiliate1 subsidi>y1 or ag5t   
has a contract or agreem5t to provide   
ph>macy b5efit managem5t s]vices2  7,b7 
ea* fee1 m>kup1 & disc\nt *>g$ or impos$
 by ! ph>macy b5efit manag]1 affiliate1 
subsidi>y1 or ag5t to ea* heal? plan1   
pay]1 & ph>macy ) :i* ! ph>macy b5efit  
manag]1 affiliate1 subsidi>y1 or ag5t   
has a contract or agreem5t = ph>macy    
b5efit managem5t s]vices2 or  7,c7 !    
aggregate am\nt ( all remun]ation !     
ph>macy b5efit manag] receives f a      

prescription drug manufactur] = a       
prescription drug1 includ+ any rebate1  
disc\nt1 adm9i/ration fee1 & any o!r    
paym5t or cr$it obta9$ or reta9$ by !   
ph>macy b5efit manag]1 or affiliate1    
subsidi>y1 or ag5t ( ! ph>macy b5efit   
manag]1 pursuant to a contract or       
agreem5t = ph>macy b5efit managem5t     
s]vices to a heal? plan1 pay]1 or any   
,f$]al ag5cy 7^u ! reque/ ( ! ag5cy74   
#c4 ,prohibition on false in=mation ,x  
%all be unlawful = any p]son to report  
in=mation relat$ to ph>macy b5efit      
managem5t s]vices to a ,f$]al dep>tm5t  
or ag5cy if-- 7#a7 ! p]son knew1 or     
reasonably %\ld h kn[n1 ! in=mation to  
be false or mislead+2  7#b7 ! in=mation 
0 requir$ by law to be report$2 &  7#c7 
! false or mislead+ in=mation report$ by
 ! p]son w\ld affect analysis or        
in=mation compil$ by ! ,f$]al dep>tm5t  
or ag5cy = /ati/ical or analytical      
purposes ) respect to ! m>ket = ph>macy 
b5efit managem5t s]vices4  #d4          
,transp>5cy  7a7 ,report+ by ph>macy    

b5efit manag]s ,n lat] ?an #a ye> aft] !
 date ( enactm5t ( ?is ,act1 & annually 
!reaft]1 ea* ph>macy b5efit manag] 7or  
affiliate1 subsidi>y1 or ag5t ( a       
ph>macy b5efit manag]7 %all report to ! 
,commission ! foll[+ in=mation3 7#a7 ,! 
aggregate am\nt ( ! diff]5ce betwe5 !   
am\nt ! ph>macy b5efit manag] 0 paid by 
ea* heal? plan & ! am\nt t ! ph>macy    
b5efit manag] paid ea* ph>macy on behalf
 ( ! heal? plan = prescription drugs4   
7#b7 ,! aggregate am\nt ( any-- 7,a7    
g5]ic effective rate fee *>g$ to ea*    
ph>macy2  7,b7 direct & indirect        
remun]ation fee *>g$ or o!r price       
concession to ea* ph>macy2 &  7,c7      
paym5t resc9d$ or o!rwise claw$ back f a
 reimbursem5t made to ea* ph>macy4  7#c7
 ,if1 dur+ ! report+ ye>1 ! ph>macy     
b5efit manag] mov$ or reassign$ a       
prescription drug to a =mul>y ti] t has 
a high] co/1 high] copaym5t1 high]      
co9surance1 or high] d$uctible to a     
consum]1 or a l[] reimbursem5t to a     
ph>macy1 an explanation ( ! reason :y ! 

drug 0 mov$ or reassign$ f #a ti] to    
ano!r1 includ+ :e!r ! move or           
reassignm5t 0 det]m9$ or reque/$ by a   
prescription drug manufactur] or o!r    
entity4  7#d7 ,) respect to any ph>macy 
b5efit manag] t owns1 controls1 or is   
affiliat$ ) a ph>macy1 a report reg>d+  
any diff]5ce 9 reimbursem5t rates or    
practices1 direct & indirect remun]ation
 fees or o!r price concessions1 &       
clawbacks betwe5 a ph>macy t is own$1   
controll$1 or affiliat$ ) ! ph>macy     
b5efit manag] & any o!r ph>macy4  7b7   
,report to ,congress  7#a7 ,9 g5]al ,n  
lat] ?an #a ye> aft] ! date ( enactm5t (
 ?is ,act1 & annually !reaft]1 !        
,commission %all submit to ! ,committee 
on ,comm]ce1 ,sci5ce1 & ,transportation 
( ! ,s5ate & ! ,committee on ,en]gy &   
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report t addresses1 at a m9imum-- 7,a7 !
 numb] actions br\ght by ! ,commission  
dur+ ! report+ ye> to en=ce ?is ,act & !
 outcome ( ea* su* en=cem5t action2     
7,b7 ! numb] ( op5 inve/igations or     

inquiries into pot5tial violations ( ?is
 ,act z ( ! "t ! report is submitt$2    
7,c7 ! numb] & nature ( compla9ts       
receiv$ by ! ,commission relat+ to an   
allegation ( a violation ( ?is ,act dur+
 ! report+ ye>2  7,d7 an anonymiz$      
summ>y ( ! reports fil$ ) ! ,commission 
pursuant to subsection 7a7 = ! report+  
ye>2 &  7,e7 policy or legislative      
recomm5dations to /r5g!n any en=cem5t   
action relat+ to a violation ( ?is ,act1
 includ+ recomm5dations to include      
additional prohibit$ conduct$ 9 section 
#b7;a74  7#b7 ,=mul>y design or placem5t
 practices ,n lat] ?an #a ye> aft] !    
date ( enactm5t ( ?is ,act1 !           
,commission %all submit to ! ,committee 
on ,comm]ce1 ,sci5ce1 & ,transportation 
( ! ,s5ate & ! ,committee on ,en]gy &   
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report t addresses ! policies1          
practices1 & role ( ph>macy b5efit      
manag]s 7includ+ _! affiliates1         
subsidi>ies1 & ag5ts7 reg>d+ =mul>y     
design or placem5t1 includ+ :e!r-- 7,a7 

ph>macy b5efit manag]s 7includ+ _!      
affiliates1 subsidi>ies1 & ag5ts7 use   
=mul>y design or placem5t to increase _!
 gross rev5ue )\t an accompany+ increase
 9 pati5t access or decrease 9 pati5t   
co/2 or  7,b7 su* policies or practices 
( ph>macy b5efit manag]s reg>d+ =mul>y  
design or placem5t violate section      
#e7;a7 ( ! ,f$]al ,trade ,commission    
,act 7#de ,u4,s4,c4 #de7;a774  7#c7     
,con/ruction ,no?+ 9 ?is section %all be
 con/ru$ z au?oriz+ ! ,commission to    
disclose any in=mation t is a trade     
secret or confid5tial in=mation describ$
 9 section #eeb7;b77#d7 ( title #e1     
,unit$ ,/ates ,code4  #e4 ,:i/lebl[]    
protections  7a7 ,9 g5]al ,a ph>macy    
b5efit manag]1 heal? plan1 ph>maceutical
 manufactur]1 ph>macy1 or any affiliate1
 subsidi>y1 or ag5t !re( %all n1        
directly or indirectly1 dis*>ge1 demote1
 susp5d1 dim9i%1 or )draw b5efits f1    
?reat51 h>ass1 or 9 any o!r mann]       
discrim9ate aga9/ or adv]sely impact a  
cov]$ individual because-- 7#a7 ! cov]$ 

individual1 or anyone p]ceiv$ z assi/+ !
 cov]$ individual1 takes 7or is suspect$
 to h tak5 or w take7 a lawful action 9 
provid+ to ,congress1 an ag5cy ( !      
,f$]al ,gov]nm5t1 ! attorney g5]al ( a  
,/ate1 a ,/ate regulator ) au?ority ov] 
! di/ribution or insurance cov]age (    
prescription drugs1 or a law en=cem5t   
ag5cy relat+ to any act or omission t ! 
cov]$ individual reasonably believes to 
be a violation ( ?is ,act2  7#b7 ! cov]$
 individual provides in=mation t ! cov]$
 individual reasonably believes evid5ces
 su* a violation to-- 7,a7 a p]son )    
sup]visory au?ority ov] ! cov]$         
individual at ! ph>macy b5efit manag]1  
heal? plan1 ph>maceutical manufactur]1  
ph>macy1 or any affiliate1 subsidi>y1 or
 ag5t !re(2 or  7,b7 ano!r individual   
work+ = ! ph>macy b5efit manag]1 heal?  
plan1 ph>maceutical manufactur]1        
ph>macy1 or any affiliate1 subsidi>y1 or
 ag5t !re( :o ! cov]$ individual        
reasonably believes has ! au?ority to   
inve/igate1 discov]1 or t]m9ate !       

violation or to take any o!r action to  
address ! violation2  7#c7 ! cov]$      
individual te/ifies 7or x is suspect$ t 
! cov]$ individual w te/ify7 9 an       
inve/igation or judicial or adm9i/rative
 proce$+ conc]n+ su* a violation2  7#d7 
! cov]$ individual assi/s or p>ticipates
 7or x is expect$ t ! cov]$ individual w
 assi/ or p>ticipate7 9 su* an          
inve/igation or judicial or adm9i/rative
 proce$+2 or  7#e7 ! cov]$ individual   
takes any o!r action to assi/ 9 c>ry+   
out ! purposes ( ?is ,act4  7b7         
,en=cem5t ,an individual :o alleges any 
adv]se action 9 violation ( subsection  
7a7 may br+ an action = a jury trial 9 !
 appropriate di/rict c\rt ( ! ,unit$    
,/ates = ! foll[+ relief3 7#a7 ,tempor>y
 relief :ile ! case is p5d+4  7#b7      
,re9/atem5t ) ! same s5iority /atus t ! 
individual w\ld h _h1 b = ! dis*>ge or  
discrim9ation4  7#c7 ,twice ! am\nt (   
back pay o!rwise ow$ to ! individual1 ) 
int]e/4  7#d7 ,consequ5tial &           
comp5satory damages1 & comp5sation =    

litigation co/s1 exp]t witness fees1 &  
reasonable attorneys' fees4  7c7 ,waiv] 
( rights & rem$ies ,! rights & rem$ies  
provid$ = 9 ?is section %all n be waiv$ 
by any policy =m or condition (         
employm5t1 includ+ by a pr$ispute       
arbitration agreem5t4  7d7 ,pr$ispute   
arbitration agreem5ts ,no pr$ispute     
arbitration agreem5t %all be valid or   
en=ceable if ! agreem5t requires        
arbitration ( a dispute aris+ "u ?is    
section4  #f4 ,en=cem5t  7a7 ,en=cem5t  
by ! ,commission  7#a7 ,unfair &        
deceptive acts or practices ,a violation
 ( ?is ,act %all be treat$ z a violation
 ( a rule def9+ an unfair or deceptive  
act or practice "u section              
#ah7;a77#a77;,b7 ( ! ,f$]al ,trade      
,commission ,act 7#ae ,u4,s4,c4         
#eg;a7a77#a77;,b774  7#b7 ,p[]s ( !     
,commission  7,a7 ,9 g5]al ,except z    
provid$ 9 subp>agraph 7,c71 !           
,commission %all en=ce ?is ,act 9 ! same
 mann]1 by ! same means1 & ) ! same     
jurisdiction1 p[]s1 & duties z ?\gh all 

applicable t]ms & provisions ( ! ,f$]al 
,trade ,commission ,act 7#ae ,u4,s4,c4  
#da et seq47 7 incorporat$ into & made a
 "p ( ?is ,act4  7,b7 ,privileges &     
immunities ,subject to p>agraph 7#c71   
any p]son :o violates ?is ,act %all be  
subject to ! p5alties & entitl$ to !    
privileges & immunities provid$ 9 !     
,f$]al ,trade ,commission ,act 7#ae     
,u4,s4,c4 #da et4 seq474  7,c7 ,nonpr(it
 organizations & insurance ,not)/&+     
section #d or #f ( ! ,f$]al ,trade      
,commission ,act 7#ae ,u4,s4,c4 #dd1    
#df71 section #b ( ,mc,carran-,f]guson  
,act 7#ae ,u4,s4,c4 #ajab71 or any o!r  
jurisdictional limitation ( !           
,commission1 ! ,commission %all also    
en=ce ?is ,act1 9 ! same mann] provid$ 9
 subp>agraphs 7,a7 & 7,b7 ( ?is         
p>agraph1 ) respect to-- 7i7            
organizations n organiz$ to c>ry on     
bus9ess = _! own pr(it or t ( _! memb]s2
 &  7ii7 ! bus9ess ( insurance1 & p]sons
 engag$ 9 su* bus9ess4  7,d7 ,au?ority  
pres]v$ ,no?+ 9 ?is section %all be     

con/ru$ to limit ! au?ority ( !         
,commission "u any o!r provision ( law4 
7#c7 ,p5alties  7,a7 ,additional civil  
p5alty ,9 addition to any p5alty        
applicable "u ! ,f$]al ,trade           
,commission ,act 7#ae ,u4,s4,c4 #da et  
seq471 any p]son t violates ?is ,act    
%all be liable = a civil p5alty ( n m   
?an #a1jjj1jjj4  7,b7 ,me?od ,! p5alties
 provid$ by subp>agraph 7,a7 %all be    
obta9$ 9 ! same mann] z civil p5alties  
impos$ "u section #ah7;a77#a77;,b7 ( !  
,f$]al ,trade ,commission ,act 7#ae     
,u4,s4,c4 #eg;a7a77#a77;,b774  7,c7     
,multiple (f5ses2 mitigat+ factors ,9   
assess+ a p5alty "u subp>agraph 7,a7--  
7i7 ea* day ( a cont9u+ violation %all  
be consid]$ a sep>ate violation2 &  7ii7
 ! c\rt %all take into consid]ation1    
among o!r factors-- 7,i7 ! s]i\sness ( !
 violation2  7,,ii7 ! ef=ts ( ! p]son   
committ+ ! violation to rem$y ! h>m     
caus$ by ! violation 9 a timely mann]2 &
  7,,iii7 :e!r ! violation 0 int5tional4
  7b7 ,en=cem5t by ,/ates  7#a7 ,9 g5]al

 ,if ! attorney g5]al ( a ,/ate has     
reason to believe t an int]e/ ( !       
resid5ts ( ! ,/ate has be5 or is be+    
?reat5$ or adv]sely affect$ by a        
practice t violates ?is ,act1 ! attorney
 g5]al ( ! ,/ate may br+ a civil action 
on behalf ( ! resid5ts ( ! ,/ate 9 an   
appropriate di/rict c\rt ( ! ,unit$     
,/ates to obta9 appropriate relief4     
7#b7 ,rights ( ! ,commission  7,a7      
,notice to ! ,commission  7i7 ,9 g5]al  
,except z provid$ 9 clause 7iii71 !     
attorney g5]al ( a ,/ate1 be=e initiat+ 
a civil action "u p>agraph 7#a71 %all   
provide writt5 notification to !        
,commission t ! attorney g5]al int5ds to
 br+ su* civil action4  7ii7 ,cont5ts ,!
 notification requir$ "u clause 7i7 %all
 include a copy ( ! compla9t to be fil$ 
to initiate ! civil action4  7iii7      
,exception ,if x is n feasible = !      
attorney g5]al ( a ,/ate to provide !   
notification requir$ "u clause 7i7 be=e 
initiat+ a civil action "u p>agraph     
7#a71 ! attorney g5]al %all notify !    

,commission imm$iately ^u in/itut+ !    
civil action4  7,b7 ,int]v5tion by !    
,commission ,! ,commission may-- 7i7    
int]v5e 9 any civil action br\ght by !  
attorney g5]al ( a ,/ate "u p>agraph    
7#a72 &  7ii7 ^u int]v5+-- 7,i7 be he>d 
on all matt]s aris+ 9 ! civil action2 & 
7,,ii7 file petitions = appeal ( a      
decision 9 ! civil action4  7#c7        
,con/ruction ,no?+ 9 ?is subsection may 
be con/ru$ to prev5t ! attorney g5]al ( 
a ,/ate f ex]cis+ ! p[]s conf]r$ on !   
attorney g5]al by ! laws ( ! ,/ate to   
conduct inve/igations1 to adm9i/] oa?s  
or affirmations1 or to compel !         
att5dance ( witnesses or ! production ( 
docum5t>y or o!r evid5ce4  7#d7 ,v5ue2  
s]vice ( process  7,a7 ,v5ue ,any action
 br\ght "u p>agraph 7#a7 may be br\ght  
9-- 7i7 ! di/rict c\rt ( ! ,unit$ ,/ates
 t meets applicable requirem5ts relat+  
to v5ue "u section #acia ( title #bh1   
,unit$ ,/ates ,code2 or  7ii7 ano!r c\rt
 ( compet5t jurisdiction4  7,b7 ,s]vice 
( process ,9 an action br\ght "u        

p>agraph 7#a71 process may be s]v$ 9 any
 di/rict 9 :i*-- 7i7 ! def5dant is an   
inhabitant1 may be f\nd1 or transacts   
bus9ess2 or  7ii7 v5ue is prop] "u      
section #acia ( title #bh1 ,unit$ ,/ates
 ,code4  7#e7 ,actions by o!r ,/ate     
(ficials  7,a7 ,9 g5]al ,9 addition to a
 civil action br\ght by an attorney     
g5]al "u p>agraph 7#a71 any o!r (fic] ( 
a ,/ate :o is au?oriz$ by ! ,/ate to d s
 may br+ a civil action "u p>agraph     
7#a71 subject to ! same requirem5ts &   
limitations t apply "u ?is subsection to
 civil actions br\ght by attorneys      
g5]al4  7,b7 ,sav+s provision ,no?+ 9   
?is subsection may be con/ru$ to        
prohibit an au?oriz$ (ficial ( a ,/ate f
 initiat+ or cont9u+ any proce$+ 9 a    
c\rt ( ! ,/ate = a violation ( any civil
 or crim9al law ( ! ,/ate4  7c7         
,affirmative def5se ,9 an action br\ght 
"u ?is section to en=ce section #b1 x   
%all be an affirmative def5se1 on :i* ! 
def5dant has ! burd5 ( p]suasion by a   
prepond]ance ( ! evid5ce1 t ! conduct   

alleg$ to be a violation ( section #b 0 
nonpretextual & reasonably necess>y to--
 7#a7 prev5t a violation (1 or comply )1
 ,f$]al or ,/ate law2  7#b7 protect     
pati5t safety2 or  7#c7 protect pati5t  
access4  #g4 ,effect on ,/ate laws ,no?+
 9 ?is ,act %all be con/ru$ to preempt1 
displace1 or supplant any ,/ate laws1   
rules1 regulations1 or requirem5ts1 or !
 en=cem5t !re(4  #h4 ,def9itions ,9 ?is 
,act3 7#a7 ,commission ,! t]m           
,commission means ! ,f$]al ,trade       
,commission4  7#b7 ,cov]$ individual ,! 
t]m cov]$ individual means a curr5t or  
=m] employee1 contractor1 subcontractor1
 s]vice provid]1 or ag5t ( a ph>macy    
b5efit manag]1 heal? plan1 ph>maceutical
 manufactur]1 ph>macy1 or any affiliate1
 subsidi>y1 or ag5t !re(4  7#c7 ,heal?  
plan ,! t]m heal? plan means any gr\p or
 individual heal? insurance plan or     
cov]age1 includ+ any heal? insurance    
plan or cov]age sponsor$ or fund$ by !  
,f$]al ,gov]nm5t or ! gov]nm5t ( any    
,/ate1 ,t]ritory1 or subdivision !re(4  

7#d7 ,ph>macy b5efit manag] ,! t]m      
ph>macy b5efit manag] means any entity t
 provides ph>macy b5efit managem5t      
s]vices on behalf ( a heal? plan1 a     
pay]1 or heal? insurance issu]4  7#e7   
,ph>macy b5efit managem5t s]vices ,! t]m
 ph>macy b5efit managem5t s]vices means1
 pursuant to a writt5 agreem5t ) a pay] 
or heal? plan (f]+ gr\p or individual   
heal? insurance cov]age1 directly or    
?r\gh an int]m$i>y1 ! s]vice (-- 7,a7   
negotiat+ t]ms & conditions1 includ+    
rebates & price concessions1 ) respect  
to a prescription drug on behalf ( !    
heal? plan1 cov]age1 or pay]2 or  7,b7  
manag+ ! prescription drug b5efits      
provid$ by ! heal? plan1 cov]age1 or    
pay]1 :i* may include =mul>y managem5t !
 process+ & paym5t ( claims =           
prescription drugs1 ! p]=mance ( drug   
utilization review1 ! process+ ( drug   
prior au?orization reque/s1 !           
adjudication ( appeals or grievances    
relat$ to ! prescription drug b5efit1   
contract+ ) network ph>macies1 or !     

provision ( relat$ s]vices4  7#f7       
,prescription drug ,! t]m prescription  
drug means-- 7,a7 a drug1 z t t]m is    
def9$ 9 section #bja7;g7 ( ! ,f$]al     
,food1 ,drug1 & ,cosmetic ,act 7#ba     
,u4,s4,c4 #cba7;g771 t is-- 7i7 approv$ 
by ! ,food & ,drug ,adm9i/ration "u     
section #eje ( su* ,act 7#ba ,u4,s4,c4  
#cee72 &  7ii7 subject to ! requirem5ts 
( section #ejc7;b77#a7 ( su* ,act 7#ba  
,u4,s4,c4 #cec7;b77#a772  7,b7 a        
biological product z t t]m is def9$ 9   
section #cea ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bfb7;i77#a772 or   
7,c7 a product t is biosimil> to1 or    
int]*angeable )1 a biologic product "u  
section #cea ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bfb7;i774  #a4     
,%ort title ,?is ,act may be cit$ z !   
,ph>macy ,b5efit ,manag] ,transp>5cy    
,act ( #bjbb4  #b4 ,prohibition on      
unfair or deceptive prescription drug   
pric+ practices  7a7 ,conduct prohibit$ 
,except z provid$ 9 subsection 7b71 x   
%all be unlawful = any ph>macy b5efit   

manag] 7or affiliate1 subsidi>y1 or ag5t
 ( a ph>macy b5efit manag]71 directly or
 indirectly1 to engage 9 any ( ! foll[+ 
activities relat$ to ph>macy b5efit     
managem5t s]vices3 7#a7 ,*>ge a heal?   
plan or pay] a diff]5t am\nt = a        
prescription drug's +r$i5t co/ or       
disp5s+ fee ?an ! am\nt ! ph>macy b5efit
 manag] reimburses a ph>macy = !        
prescription drug's +r$i5t co/ or       
disp5s+ fee :]e ! ph>macy b5efit manag] 
reta9s ! am\nt ( any su* diff]5ce4  7#b7
 ,arbitr>ily1 unfairly1 or deceptively1 
by contract or any o!r means1 r$uce1    
resc9d1 or o!rwise claw back any        
reimbursem5t paym5t1 9 :ole or 9 "p1 to 
a ph>maci/ or ph>macy = a prescription  
drug's +r$i5t co/ or disp5s+ fee4  7#c7 
,arbitr>ily1 unfairly1 or deceptively1  
by contract or any o!r means1 increase  
fees or l[] reimbursem5t to a ph>macy 9 
ord] to (fset reimbursem5t *anges       
in/ruct$ by ! ,f$]al ,gov]nm5t "u any   
heal? plan fund$ by ! ,f$]al ,gov]nm5t4 
7b7 ,exceptions ,a ph>macy b5efit manag]

 %all n be 9 violation ( subsection 7a7 
if ! ph>macy b5efit manag] meets !      
foll[+ conditions3 7#a7 ,! ph>macy      
b5efit manag]1 affiliate1 subsidi>y1 or 
ag5t passes along or returns #ajj p]c5t 
( any price concession to a heal? plan  
or pay]1 includ+ any rebate1 disc\nt1 or
 o!r price concession4  7#b7 ,! ph>macy 
b5efit manag]1 affiliate1 subsidi>y1 or 
ag5t provides full & complete disclosure
 (-- 7,a7 ! co/1 price1 & reimbursem5t (
 ! prescription drug to ea* heal? plan1 
pay]1 & ph>macy ) :i* ! ph>macy b5efit  
manag]1 affiliate1 subsidi>y1 or ag5t   
has a contract or agreem5t to provide   
ph>macy b5efit managem5t s]vices2  7,b7 
ea* fee1 m>kup1 & disc\nt *>g$ or impos$
 by ! ph>macy b5efit manag]1 affiliate1 
subsidi>y1 or ag5t to ea* heal? plan1   
pay]1 & ph>macy ) :i* ! ph>macy b5efit  
manag]1 affiliate1 subsidi>y1 or ag5t   
has a contract or agreem5t = ph>macy    
b5efit managem5t s]vices2 or  7,c7 !    
aggregate am\nt ( all remun]ation !     
ph>macy b5efit manag] receives f a      

prescription drug manufactur] = a       
prescription drug1 includ+ any rebate1  
disc\nt1 adm9i/ration fee1 & any o!r    
paym5t or cr$it obta9$ or reta9$ by !   
ph>macy b5efit manag]1 or affiliate1    
subsidi>y1 or ag5t ( ! ph>macy b5efit   
manag]1 pursuant to a contract or       
agreem5t = ph>macy b5efit managem5t     
s]vices to a heal? plan1 pay]1 or any   
,f$]al ag5cy 7^u ! reque/ ( ! ag5cy74   
#c4 ,prohibition on false in=mation ,x  
%all be unlawful = any p]son to report  
in=mation relat$ to ph>macy b5efit      
managem5t s]vices to a ,f$]al dep>tm5t  
or ag5cy if-- 7#a7 ! p]son knew1 or     
reasonably %\ld h kn[n1 ! in=mation to  
be false or mislead+2  7#b7 ! in=mation 
0 requir$ by law to be report$2 &  7#c7 
! false or mislead+ in=mation report$ by
 ! p]son w\ld affect analysis or        
in=mation compil$ by ! ,f$]al dep>tm5t  
or ag5cy = /ati/ical or analytical      
purposes ) respect to ! m>ket = ph>macy 
b5efit managem5t s]vices4  #d4          
,transp>5cy  7a7 ,report+ by ph>macy    

b5efit manag]s ,n lat] ?an #a ye> aft] !
 date ( enactm5t ( ?is ,act1 & annually 
!reaft]1 ea* ph>macy b5efit manag] 7or  
affiliate1 subsidi>y1 or ag5t ( a       
ph>macy b5efit manag]7 %all report to ! 
,commission ! foll[+ in=mation3 7#a7 ,! 
aggregate am\nt ( ! diff]5ce betwe5 !   
am\nt ! ph>macy b5efit manag] 0 paid by 
ea* heal? plan & ! am\nt t ! ph>macy    
b5efit manag] paid ea* ph>macy on behalf
 ( ! heal? plan = prescription drugs4   
7#b7 ,! aggregate am\nt ( any-- 7,a7    
g5]ic effective rate fee *>g$ to ea*    
ph>macy2  7,b7 direct & indirect        
remun]ation fee *>g$ or o!r price       
concession to ea* ph>macy2 &  7,c7      
paym5t resc9d$ or o!rwise claw$ back f a
 reimbursem5t made to ea* ph>macy4  7#c7
 ,if1 dur+ ! report+ ye>1 ! ph>macy     
b5efit manag] mov$ or reassign$ a       
prescription drug to a =mul>y ti] t has 
a high] co/1 high] copaym5t1 high]      
co9surance1 or high] d$uctible to a     
consum]1 or a l[] reimbursem5t to a     
ph>macy1 an explanation ( ! reason :y ! 

drug 0 mov$ or reassign$ f #a ti] to    
ano!r1 includ+ :e!r ! move or           
reassignm5t 0 det]m9$ or reque/$ by a   
prescription drug manufactur] or o!r    
entity4  7#d7 ,) respect to any ph>macy 
b5efit manag] t owns1 controls1 or is   
affiliat$ ) a ph>macy1 a report reg>d+  
any diff]5ce 9 reimbursem5t rates or    
practices1 direct & indirect remun]ation
 fees or o!r price concessions1 &       
clawbacks betwe5 a ph>macy t is own$1   
controll$1 or affiliat$ ) ! ph>macy     
b5efit manag] & any o!r ph>macy4  7b7   
,report to ,congress  7#a7 ,9 g5]al ,n  
lat] ?an #a ye> aft] ! date ( enactm5t (
 ?is ,act1 & annually !reaft]1 !        
,commission %all submit to ! ,committee 
on ,comm]ce1 ,sci5ce1 & ,transportation 
( ! ,s5ate & ! ,committee on ,en]gy &   
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report t addresses1 at a m9imum-- 7,a7 !
 numb] actions br\ght by ! ,commission  
dur+ ! report+ ye> to en=ce ?is ,act & !
 outcome ( ea* su* en=cem5t action2     
7,b7 ! numb] ( op5 inve/igations or     

inquiries into pot5tial violations ( ?is
 ,act z ( ! "t ! report is submitt$2    
7,c7 ! numb] & nature ( compla9ts       
receiv$ by ! ,commission relat+ to an   
allegation ( a violation ( ?is ,act dur+
 ! report+ ye>2  7,d7 an anonymiz$      
summ>y ( ! reports fil$ ) ! ,commission 
pursuant to subsection 7a7 = ! report+  
ye>2 &  7,e7 policy or legislative      
recomm5dations to /r5g!n any en=cem5t   
action relat+ to a violation ( ?is ,act1
 includ+ recomm5dations to include      
additional prohibit$ conduct$ 9 section 
#b7;a74  7#b7 ,=mul>y design or placem5t
 practices ,n lat] ?an #a ye> aft] !    
date ( enactm5t ( ?is ,act1 !           
,commission %all submit to ! ,committee 
on ,comm]ce1 ,sci5ce1 & ,transportation 
( ! ,s5ate & ! ,committee on ,en]gy &   
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report t addresses ! policies1          
practices1 & role ( ph>macy b5efit      
manag]s 7includ+ _! affiliates1         
subsidi>ies1 & ag5ts7 reg>d+ =mul>y     
design or placem5t1 includ+ :e!r-- 7,a7 

ph>macy b5efit manag]s 7includ+ _!      
affiliates1 subsidi>ies1 & ag5ts7 use   
=mul>y design or placem5t to increase _!
 gross rev5ue )\t an accompany+ increase
 9 pati5t access or decrease 9 pati5t   
co/2 or  7,b7 su* policies or practices 
( ph>macy b5efit manag]s reg>d+ =mul>y  
design or placem5t violate section      
#e7;a7 ( ! ,f$]al ,trade ,commission    
,act 7#ae ,u4,s4,c4 #de7;a774  7#c7     
,con/ruction ,no?+ 9 ?is section %all be
 con/ru$ z au?oriz+ ! ,commission to    
disclose any in=mation t is a trade     
secret or confid5tial in=mation describ$
 9 section #eeb7;b77#d7 ( title #e1     
,unit$ ,/ates ,code4  7c7 ,,gao /udy ,n 
lat] ?an #a ye> aft] ! date ( enactm5t (
 ?is ,act1 ! ,comptroll] ,g5]al ( !     
,unit$ ,/ates %all submit to !          
,committee on ,f9ance & ! ,committee on 
,heal?1 ,education1 ,labor1 & ,p5sions (
 ! ,s5ate & to ! ,committee on ,ways &  
,means & ! ,committee on ,en]gy &       
,comm]ce ( ! ,h\se ( ,repres5tatives a  
report t-- 7#a7 addresses1 at m9imum--  

7,a7 ! role t ph>macy b5efit manag]s    
play 9 ! ph>maceutical supply *a92  7,b7
 ! /ate ( competition among ph>macy     
b5efit manag]s1 includ+ ! m>ket %>e = ! 
,nation's #aj l>ge/ ph>macy b5efit      
manag]s2  7,c7 ! use ( rebates & fees by
 ph>macy b5efit manag]s1 includ+ data = 
ea* ( ! #aj l>ge/ ph>macy b5efit manag]s
 t reflects1 = ea* drug 9 ! =mul>y ( ea*
 su* ph>macy b5efit manag]-- 7i7 ! am\nt
 ( ! rebate pass$ on to pati5ts2  7ii7 !
 am\nt ( ! rebate pass$ on to payors2   
7iii7 ! am\nt ( ! rebate kept by !      
ph>macy b5efit manag]2 &  7iv7 ! role ( 
fees *>g$ by ! ph>macy b5efit manag]2   
7,d7 :e!r ph>macy b5efit manag]s        
/ructure _! =mul>ies 9 favor (          
high-rebate prescription drugs ov]      
l[]-co/1 l[]-rebate alt]natives2  7,e7 !
 av]age prior au?orization approval "t =
 ea* ( ! #aj l>ge/ ph>macy b5efit       
manag]s2  7,f7 factors affect+ ! use (  
/ep !rapy 9 ea* ( ! #aj l>ge/ ph>macy   
b5efit manag]s2 &  7,g7 ! ext5t to :i* !
 price t ph>macy b5efit manag]s *>ge    

payors1 su* z ! ,m$ic>e program "u title
 ,,xxviii ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acie et seq471 ,/ate    
,m$icaid programs "u title ,,xix ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq471 ! ,f$]al ,employees     
,heal? ,b5efits ,program "u *apt] #hi ( 
title #e1 ,unit$ ,/ates ,code1 or       
private payors1 = a drug is m ?an su*   
ph>macy b5efit manag]s pay ! ph>macy = !
 drug2 &  7#b7 provides recomm5dations =
 legislative action to l[] ! co/ (      
prescription drugs = consum]s & payors1 
improve ! effici5cy ( ! ph>maceutical   
supply *a9 by l[]+ int]m$i>y co/s1      
improve competition 9 ph>macy b5efit    
managem5t1 & provide transp>5cy 9       
ph>macy b5efit managem5t4  #e4          
,:i/lebl[] protections  7a7 ,9 g5]al ,a 
ph>macy b5efit manag]1 heal? plan1      
ph>maceutical manufactur]1 ph>macy1 or  
any affiliate1 subsidi>y1 or ag5t !re(  
%all n1 directly or indirectly1 dis*>ge1
 demote1 susp5d1 dim9i%1 or )draw       
b5efits f1 ?reat51 h>ass1 or 9 any o!r  

mann] discrim9ate aga9/ or adv]sely     
impact a cov]$ individual because-- 7#a7
 ! cov]$ individual1 or anyone p]ceiv$ z
 assi/+ ! cov]$ individual1 takes 7or is
 suspect$ to h tak5 or w take7 a lawful 
action 9 provid+ to ,congress1 an ag5cy 
( ! ,f$]al ,gov]nm5t1 ! attorney g5]al (
 a ,/ate1 a ,/ate regulator ) au?ority  
ov] ! di/ribution or insurance cov]age (
 prescription drugs1 or a law en=cem5t  
ag5cy relat+ to any act or omission t ! 
cov]$ individual reasonably believes to 
be a violation ( ?is ,act2  7#b7 ! cov]$
 individual provides in=mation t ! cov]$
 individual reasonably believes evid5ces
 su* a violation to-- 7,a7 a p]son )    
sup]visory au?ority ov] ! cov]$         
individual at ! ph>macy b5efit manag]1  
heal? plan1 ph>maceutical manufactur]1  
ph>macy1 or any affiliate1 subsidi>y1 or
 ag5t !re(2 or  7,b7 ano!r individual   
work+ = ! ph>macy b5efit manag]1 heal?  
plan1 ph>maceutical manufactur]1        
ph>macy1 or any affiliate1 subsidi>y1 or
 ag5t !re( :o ! cov]$ individual        

reasonably believes has ! au?ority to   
inve/igate1 discov]1 or t]m9ate !       
violation or to take any o!r action to  
address ! violation2  7#c7 ! cov]$      
individual te/ifies 7or x is suspect$ t 
! cov]$ individual w te/ify7 9 an       
inve/igation or judicial or adm9i/rative
 proce$+ conc]n+ su* a violation2  7#d7 
! cov]$ individual assi/s or p>ticipates
 7or x is expect$ t ! cov]$ individual w
 assi/ or p>ticipate7 9 su* an          
inve/igation or judicial or adm9i/rative
 proce$+2 or  7#e7 ! cov]$ individual   
takes any o!r action to assi/ 9 c>ry+   
out ! purposes ( ?is ,act4  7b7         
,en=cem5t ,an individual :o alleges any 
adv]se action 9 violation ( subsection  
7a7 may br+ an action = a jury trial 9 !
 appropriate di/rict c\rt ( ! ,unit$    
,/ates = ! foll[+ relief3 7#a7 ,tempor>y
 relief :ile ! case is p5d+4  7#b7      
,re9/atem5t ) ! same s5iority /atus t ! 
individual w\ld h _h1 b = ! dis*>ge or  
discrim9ation4  7#c7 ,twice ! am\nt (   
back pay o!rwise ow$ to ! individual1 ) 

int]e/4  7#d7 ,consequ5tial &           
comp5satory damages1 & comp5sation =    
litigation co/s1 exp]t witness fees1 &  
reasonable attorneys' fees4  7c7 ,waiv] 
( rights & rem$ies ,! rights & rem$ies  
provid$ = 9 ?is section %all n be waiv$ 
by any policy =m or condition (         
employm5t1 includ+ by a pr$ispute       
arbitration agreem5t4  7d7 ,pr$ispute   
arbitration agreem5ts ,no pr$ispute     
arbitration agreem5t %all be valid or   
en=ceable if ! agreem5t requires        
arbitration ( a dispute aris+ "u ?is    
section4  #f4 ,en=cem5t  7a7 ,en=cem5t  
by ! ,commission  7#a7 ,unfair &        
deceptive acts or practices ,a violation
 ( ?is ,act %all be treat$ z a violation
 ( a rule def9+ an unfair or deceptive  
act or practice "u section              
#ah7;a77#a77;,b7 ( ! ,f$]al ,trade      
,commission ,act 7#ae ,u4,s4,c4         
#eg;a7a77#a77;,b774  7#b7 ,p[]s ( !     
,commission  7,a7 ,9 g5]al ,except z    
provid$ 9 subp>agraph 7,c71 !           
,commission %all en=ce ?is ,act 9 ! same

 mann]1 by ! same means1 & ) ! same     
jurisdiction1 p[]s1 & duties z ?\gh all 
applicable t]ms & provisions ( ! ,f$]al 
,trade ,commission ,act 7#ae ,u4,s4,c4  
#da et seq47 7 incorporat$ into & made a
 "p ( ?is ,act4  7,b7 ,privileges &     
immunities ,subject to p>agraph 7#c71   
any p]son :o violates ?is ,act %all be  
subject to ! p5alties & entitl$ to !    
privileges & immunities provid$ 9 !     
,f$]al ,trade ,commission ,act 7#ae     
,u4,s4,c4 #da et4 seq474  7,c7 ,nonpr(it
 organizations & insurance ,not)/&+     
section #d or #f ( ! ,f$]al ,trade      
,commission ,act 7#ae ,u4,s4,c4 #dd1    
#df71 section #b ( ,mc,carran-,f]guson  
,act 7#ae ,u4,s4,c4 #ajab71 or any o!r  
jurisdictional limitation ( !           
,commission1 ! ,commission %all also    
en=ce ?is ,act1 9 ! same mann] provid$ 9
 subp>agraphs 7,a7 & 7,b7 ( ?is         
p>agraph1 ) respect to-- 7i7            
organizations n organiz$ to c>ry on     
bus9ess = _! own pr(it or t ( _! memb]s2
 &  7ii7 ! bus9ess ( insurance1 & p]sons

 engag$ 9 su* bus9ess4  7,d7 ,au?ority  
pres]v$ ,no?+ 9 ?is section %all be     
con/ru$ to limit ! au?ority ( !         
,commission "u any o!r provision ( law4 
7#c7 ,p5alties  7,a7 ,additional civil  
p5alty ,9 addition to any p5alty        
applicable "u ! ,f$]al ,trade           
,commission ,act 7#ae ,u4,s4,c4 #da et  
seq471 any p]son t violates ?is ,act    
%all be liable = a civil p5alty ( n m   
?an #a1jjj1jjj4  7,b7 ,me?od ,! p5alties
 provid$ by subp>agraph 7,a7 %all be    
obta9$ 9 ! same mann] z civil p5alties  
impos$ "u section #ah7;a77#a77;,b7 ( !  
,f$]al ,trade ,commission ,act 7#ae     
,u4,s4,c4 #eg;a7a7#a77;,b74  7,c7       
,multiple (f5ses2 mitigat+ factors ,9   
assess+ a p5alty "u subp>agraph 7,a7--  
7i7 ea* day ( a cont9u+ violation %all  
be consid]$ a sep>ate violation2 &  7ii7
 ! c\rt %all take into consid]ation1    
among o!r factors-- 7,i7 ! s]i\sness ( !
 violation2  7,,ii7 ! ef=ts ( ! p]son   
committ+ ! violation to rem$y ! h>m     
caus$ by ! violation 9 a timely mann]2 &

  7,,iii7 :e!r ! violation 0 int5tional4
  7b7 ,en=cem5t by ,/ates  7#a7 ,9 g5]al
 ,if ! attorney g5]al ( a ,/ate has     
reason to believe t an int]e/ ( !       
resid5ts ( ! ,/ate has be5 or is be+    
?reat5$ or adv]sely affect$ by a        
practice t violates ?is ,act1 ! attorney
 g5]al ( ! ,/ate may br+ a civil action 
on behalf ( ! resid5ts ( ! ,/ate 9 an   
appropriate di/rict c\rt ( ! ,unit$     
,/ates to obta9 appropriate relief4     
7#b7 ,rights ( ! ,commission  7,a7      
,notice to ! ,commission  7i7 ,9 g5]al  
,except z provid$ 9 clause 7iii71 !     
attorney g5]al ( a ,/ate1 be=e initiat+ 
a civil action "u p>agraph 7#a71 %all   
provide writt5 notification to !        
,commission t ! attorney g5]al int5ds to
 br+ su* civil action4  7ii7 ,cont5ts ,!
 notification requir$ "u clause 7i7 %all
 include a copy ( ! compla9t to be fil$ 
to initiate ! civil action4  7iii7      
,exception ,if x is n feasible = !      
attorney g5]al ( a ,/ate to provide !   
notification requir$ "u clause 7i7 be=e 

initiat+ a civil action "u p>agraph     
7#a71 ! attorney g5]al %all notify !    
,commission imm$iately ^u in/itut+ !    
civil action4  7,b7 ,int]v5tion by !    
,commission ,! ,commission may-- 7i7    
int]v5e 9 any civil action br\ght by !  
attorney g5]al ( a ,/ate "u p>agraph    
7#a72 &  7ii7 ^u int]v5+-- 7,i7 be he>d 
on all matt]s aris+ 9 ! civil action2 & 
7,,ii7 file petitions = appeal ( a      
decision 9 ! civil action4  7#c7        
,con/ruction ,no?+ 9 ?is subsection may 
be con/ru$ to prev5t ! attorney g5]al ( 
a ,/ate f ex]cis+ ! p[]s conf]r$ on !   
attorney g5]al by ! laws ( ! ,/ate to   
conduct inve/igations1 to adm9i/] oa?s  
or affirmations1 or to compel !         
att5dance ( witnesses or ! production ( 
docum5t>y or o!r evid5ce4  7#d7 ,v5ue2  
s]vice ( process  7,a7 ,v5ue ,any action
 br\ght "u p>agraph 7#a7 may be br\ght  
9-- 7i7 ! di/rict c\rt ( ! ,unit$ ,/ates
 t meets applicable requirem5ts relat+  
to v5ue "u section #acia ( title #bh1   
,unit$ ,/ates ,code2 or  7ii7 ano!r c\rt

 ( compet5t jurisdiction4  7,b7 ,s]vice 
( process ,9 an action br\ght "u        
p>agraph 7#a71 process may be s]v$ 9 any
 di/rict 9 :i*-- 7i7 ! def5dant is an   
inhabitant1 may be f\nd1 or transacts   
bus9ess2 or  7ii7 v5ue is prop] "u      
section #acia ( title #bh1 ,unit$ ,/ates
 ,code4  7#e7 ,actions by o!r ,/ate     
(ficials  7,a7 ,9 g5]al ,if an attorney 
g5]al lacks appropriate jurisdiction to 
br+ a civil action "u p>agraph 7#a71 any
 o!r (fic] ( a ,/ate :o is au?oriz$ by !
 ,/ate to d s may br+ a civil action "u 
p>agraph 7#a71 subject to ! same        
requirem5ts & limitations t apply "u ?is
 subsection to civil actions br\ght by  
attorneys g5]al4  7,b7 ,cl>ification (  
au?ority ,! au?ority provid$ by         
subp>agraph 7,a7 %all supplant1 & n     
supplem5t1 ! au?orities ( ,/ate         
attorneys g5]al "u p>agraph 7#a74  7,c7 
,sav+s provision ,no?+ 9 ?is subsection 
may be con/ru$ to prohibit an au?oriz$  
(ficial ( a ,/ate f initiat+ or cont9u+ 
any proce$+ 9 a c\rt ( ! ,/ate = a      

violation ( any civil or crim9al law ( !
 ,/ate4  7c7 ,affirmative def5se ,9 an  
action br\ght "u ?is section to en=ce   
section #b1 x %all be an affirmative    
def5se1 on :i* ! def5dant has ! burd5 ( 
p]suasion by a prepond]ance ( ! evid5ce1
 t ! conduct alleg$ to be a violation ( 
section #b 0 nonpretextual & reasonably 
necess>y to-- 7#a7 prev5t a violation (1
 or comply )1 ,f$]al or ,/ate law2  7#b7
 protect pati5t safety2 or  7#c7 protect
 pati5t access4  #g4 ,effect on ,/ate   
laws ,no?+ 9 ?is ,act %all be con/ru$ to
 preempt1 displace1 or supplant any     
,/ate laws1 rules1 regulations1 or      
requirem5ts1 or ! en=cem5t !re(4  #h4   
,def9itions ,9 ?is ,act3 7#a7           
,commission ,! t]m ,commission means !  
,f$]al ,trade ,commission4  7#b7 ,cov]$ 
individual ,! t]m cov]$ individual means
 a curr5t or =m] employee1 contractor1  
subcontractor1 s]vice provid]1 or ag5t (
 a ph>macy b5efit manag]1 heal? plan1   
ph>maceutical manufactur]1 ph>macy1 or  
any affiliate1 subsidi>y1 or ag5t !re(4 

7#c7 ,heal? plan ,! t]m heal? plan means
 any gr\p or individual heal? insurance 
plan or cov]age1 includ+ any heal?      
insurance plan or cov]age sponsor$ or   
fund$ by ! ,f$]al ,gov]nm5t or !        
gov]nm5t ( any ,/ate1 ,t]ritory1 or     
subdivision !re(4  7#d7 ,ph>macy b5efit 
manag] ,! t]m ph>macy b5efit manag]     
means any entity t provides ph>macy     
b5efit managem5t s]vices on behalf ( a  
heal? plan1 a pay]1 or heal? insurance  
issu]4  7#e7 ,ph>macy b5efit managem5t  
s]vices ,! t]m ph>macy b5efit managem5t 
s]vices means1 pursuant to a writt5     
agreem5t ) a pay] or heal? plan (f]+    
gr\p or individual heal? insurance      
cov]age1 directly or ?r\gh an int]m$i>y1
 ! s]vice (-- 7,a7 negotiat+ t]ms &     
conditions1 includ+ rebates & price     
concessions1 ) respect to a prescription
 drug on behalf ( ! heal? plan1 cov]age1
 or pay]2 or  7,b7 manag+ ! prescription
 drug b5efits provid$ by ! heal? plan1  
cov]age1 or pay]1 :i* may include =mul>y
 managem5t ! process+ & paym5t ( claims 

= prescription drugs1 ! p]=mance ( drug 
utilization review1 ! process+ ( drug   
prior au?orization reque/s1 !           
adjudication ( appeals or grievances    
relat$ to ! prescription drug b5efit1   
contract+ ) network ph>macies1 or !     
provision ( relat$ s]vices4  7#f7       
,prescription drug ,! t]m prescription  
drug means-- 7,a7 a drug1 z t t]m is    
def9$ 9 section #bja7;g7 ( ! ,f$]al     
,food1 ,drug1 & ,cosmetic ,act 7#ba     
,u4,s4,c4 #cba7;g771 t is-- 7i7 approv$ 
by ! ,food & ,drug ,adm9i/ration "u     
section #eje ( su* ,act 7#ba ,u4,s4,c4  
#cee72 &  7ii7 subject to ! requirem5ts 
( section #ejc7;b77#a7 ( su* ,act 7#ba  
,u4,s4,c4 #cec7;b77#a772  7,b7 a        
biological product z t t]m is def9$ 9   
section #cea ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bfb7;i77#a772 or   
7,c7 a product t is biosimil> to1 or    
int]*angeable )1 a biologic product "u  
section #cea ( ! ,public ,heal? ,s]vice 
,act 7#db ,u4,s4,c4 #bfb7;i774  ,decemb]
 #ad1 #bjbb,report$ ) an am5dm5t