Virginia legislation · 2025 Regular Session
Virginia SB1311: An Act to amend and reenact § 38.2-3465 of the Code of Virginia, relating to health insurance; pharmacy benefits managers; defin
Status: Chaptered, March 24, 2025
Health insurance; pharmacy benefits managers, definition of "covered entity."
What the bill says
An Act to amend and reenact § 38.2-3465 of the Code of Virginia, relating to health insurance; pharmacy benefits managers; definition of covered entity. [S 1311] Approved March 24, 2025 1. That § 38.2-3465 of the Code of Virginia is amended and reenacted as follows: § 38.2-3465. Definitions. A. As used in this article, unless the context requires a different meaning: "Aggregate retained rebate percentage" means the sum total dollar amount of a pharmacy benefits manager's retained rebates relating to all carrier clients of such pharmacy benefits manager divided by the sum total dollar amount of.
From the enrolled text:
An Act to amend and reenact § 38.2-3465 of the Code of Virginia, relating to health insurance; pharmacy benefits managers; definition of covered entity. [S 1311] Approved March 24, 2025 1. That § 38.2-3465 of the Code of Virginia is amended and reenacted as follows: § 38.2-3465. Definitions. A. As used in this article, unless the context requires a different meaning: "Aggregate retained rebate percentage" means the sum total dollar amount of a pharmacy benefits manager's retained rebates relating to all carrier clients of such pharmacy benefits manager divided by the sum total dollar amount of all rebates received by such pharmacy benefits manager relating to all such clients. "Carrier" has the same meaning ascribed thereto in subsection A of § 38.2-3407.15. However, "carrier" does not include a nonprofit health maintenance organization that operates as a group model whose internal pharmacy operation exclusively serves the members or patients of the nonprofit health maintenance organization. "Claim" means a request from a pharmacy or pharmacist to be reimbursed for the cost of administering, filling, or refilling a prescription for a drug or for providing a medical supply or device. "Claims processing services" means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include (i) receiving payments for pharmacist services, (ii) making payments to …