House committee substitute makes the following changes to the 1st edition.

Deletes proposed GS 58-56A-2 (Pharmacy of choice). Makes conforming technical changes.

Amends proposed GS 58-56A-3 (Consumer protections). Establishes that a pharmacy or pharmacist has the right to provide an insured information regarding the amount of the insured's cost share for a prescription drug (previously, prohibited a pharmacy benefits manager from prohibiting a pharmacist or pharmacy from providing an insured information regarding the amount of the insured's cost share for a prescription drug and the clinical efficacy of a lower-priced alternative drug if one is available). Modifies and adds to subsection (b) to prohibit a pharmacy benefits manager from prohibiting, through contract, a pharmacy from offering and providing direct and limited delivery services to an insured as an ancillary service of the pharmacy, as delineated in the contract between the pharmacy benefits manager and the pharmacy. Provides in subsection (c) that a pharmacy benefits manager cannot charge or attempt to collect from an insured a co-payment that exceeds the total submitted charges by the network pharmacy (previously specified for which the pharmacy is paid). Deletes the language of subsection (d), making a violation an unfair and deceptive trade practice and actionable under GS Chapter 75. Instead provides that any contract for the provision of a network to deliver health care services between a pharmacy manager and insurer must be made available for review by the Department of Insurance.

Amends proposed GS 58-56A-4 (Pharmacy and pharmacist protections) to now provide that a pharmacy benefits manager can only charge a fee or otherwise hold a pharmacy responsible for a fee relating to the adjudication of a claim if the fee is reported on the remittance advice of the adjudicated claim or is set out in contract between the pharmacy benefits manager and the pharmacy. Adds that the statute does not apply with respect to claims under an employee benefit plan under the Employment Retirement Security Act of 1974 or Medicare Part D. Deletes proposed subsections (b) (which prohibited a pharmacy benefits manager from recouping funds from a pharmacy in connection with claims for which the pharmacy has already been paid without first complying with GS Chapter 58, Article 4C, and from retaliating against a pharmacist or pharmacy for exercising rights under GS Chapter 58), (c) (which provided that the statute did not apply to licensed group health maintenance organizations with an exclusive medical group contract that operate their own pharmacies), and (d) (which made a violation an unfair and deceptive trade practice and actionable under GS Chapter 75, and stated that the statute did not foreclose other available remedies).