Senate committee substitute to the 2nd edition makes the following changes. Makes technical changes.

Part III.

Removes changes to GS 90-85.40 which would have specified that an independent pharmacy or pharmacist’s act of declining to provide a covered drug, device, or service as described, could not be construed to be a violation of the NC Pharmacy Practice Act (GS 80-85.40). Makes conforming changes to the section’s effective date.

Part V.

Reorganizes those provisions of deleted GS 90-85.40 into new GS 90-85.21E (concerning independent pharmacy prescriptions).

Part VIII.

Removes defined cost-sharing from what must be reduced by an amount equal to 90% of all described rebates under the provisions calculating an insured’s defined cost-sharing for a covered prescription drug at the point of sale under GS 58-3-182.

Part X.

Modifies the defined terms: (1) large retail pharmacy so that it is more than 25 pharmacies under common ownership (was termed a “chain retail pharmacy” meaning four or more pharmacies under common ownership) and (2) small retail pharmacy so that is 25 or fewer pharmacies under common ownership (was, “independent retail pharmacy” with three or fewer such pharmacies) in GS 90-85.42 (Board of Pharmacy reporting). Makes conforming changes.

Part XI.

Enacts GS 135-49, requiring that Board of Trustees (Board) for the State Health Plan for Teachers and State Employees (Plan), before awarding a Request for Proposal for Third-Party Administrative Services for the Plan, to work to determine how to incorporate the nine listed items in an economically feasible manner in the Plan, including: (1) allowing the Plan’s pharmacy benefits managers (PBM) to provide a monetary advantage to pharmacies in North Carolina neighborhoods, communities, and counties that are underserved by pharmacies; (2) preventing the Plan’s PBM’s from contractually requiring independent pharmacies to accept reimbursement for a drug, device, or pharmacy service in an amount that is less than the acquisition cost of the drug, device, or pharmacy service; and adhering to the cost-sharing consumer protection provisions of GS 58-3-182, as enacted by the act. Requires each item that the Board determines to be economically feasible to be included in the "Product and Plan Design Management Minimum Requirements" section, or any other substantially similar section of the Request for Proposal for Third-Party Administrative Services for the Plan.