Senate committee substitute to the 3rd edition makes the following changes. Makes technical changes.

Part I.

Increases the number of pharmacies from three to five that can comprise a group of common ownership under the definition of independent pharmacy in GS 58-51-37 (concerning pharmacies of choice).

Part II.

Extends the time for a Pharmacy Services Administrative Organization (PSAO) to: (1) provide a written disclosure of ownership to the Department of Insurance (DOI) under GS 58-56B-5 and (2) update any required disclosures in GS 58-56B-10 due to a material change in ownership, from within five calendar days of any material change in ownership to within ten calendar days of such change. Extends the time for a PSAO-pharmacy to provide a pharmacy with a copy of any of the described materials related to an executed PSAO-pharmacy contract from three calendar days to ten calendar days after the execution of, or amendment to, a contract that the PSAO has signed on behalf of the independent pharmacy.

Reduces the daily penalty under GS 58-56B-40 from $1,000 to $500 and specifies that the penalty accrues from the day the Insurance Commissioner informs the PSAO of noncompliance.  

Removes language specifying that a PSAO has a duty to avoid self-dealing from GS 58-56B-45. Makes technical changes.

Part III.

Adds terms independent pharmacy, pharmacy desert, and retail community pharmacy to the definitions provision of GS Chapter 58, Article 56A (pharmacy benefits management). Include retail community pharmacies in a pharmacy desert as one types of pharmacies that a pharmacy benefits manager (PBM) is prohibited from imposing the described reimbursement requirements upon in GS 56-56A-4(g).

Requires a PBM to act in the best interests of both insureds and health benefit plans offered by the insurer as part of its fiduciary duties to contracted insurers under GS 58-56A-21 (was, insureds under the health benefit plans offered by the insurer).

Part IX.

Changes the due date for the annual report under GS 90-85.58 from March 1, 2026, and annually thereafter, to January 1, 2027, and annually thereafter.

Part XI.

Now requires the Executive Administrator to consider incorporating the nine listed items in new GS 135-49 into a request for proposal for a PBM for the State Health Plan for Teachers’ and State Employees’ Plan (was, requiring that Board of Trustees (Board) for the Plan to work to determine how to incorporate the nine listed items in an economically feasible manner in the Plan). Makes conforming changes. Makes the part effective October 1, 2025, and applicable to requests for proposals issued on or after that date.