South Carolina House Bill H4793

South Carolina 2025-2026 Regular Session

• Introduced: 1/13/26
• Refer: 1/13/26

Caption

Pharmacy Benefits Managers and Pharmacy Services Administrative Organizations

Impact

The proposed amendments serve to reinforce regulatory standards for PBMs and PSAOs, ensuring that they comply with state laws regarding the management of pharmacy services. By introducing a requirement for periodic audits—every five years at a minimum—H4793 aims to protect consumers and ensure that pharmacy benefits are managed appropriately. These changes are expected to instill greater confidence in the operations of PBMs and PSAOs, potentially leading to improved transparency in how prescription drug benefits are handled.

Summary

House Bill 4793 aims to amend certain sections of the South Carolina Code of Laws concerning pharmacy benefits managers (PBMs) and pharmacy services administrative organizations (PSAOs). The bill stipulates that the examinations of these entities' books and records will now adhere to the provisions of Chapter 13, Title 38. This change seeks to enhance oversight and compliance within the pharmacy sector by mandating that these organizations undergo audits at regular intervals, thus promoting accountability in their operations related to health benefit plans.

Contention

While there may be general support for increased regulatory scrutiny in the pharmacy sector, there could also be points of contention. Stakeholders may debate the appropriateness of the costs associated with these examinations, which will be borne by the PBMs and PSAOs. Furthermore, there may be concerns about the confidentiality of the information acquired during these audits, as the bill underscores that such data will be deemed proprietary and not subject to public disclosure under the South Carolina Freedom of Information Act. This element might raise discussions regarding public access to information and accountability in healthcare management.