INSURANCE COMMISSIONER CAUSEY, AG JACKSON PEN JOINT MESSAGE TO NC'S PBMS LETTER DISCUSSES SCRIPT ACT'S CONSUMER PROTECTIONS, PROVISIONS

The following information was released by the North Carolina Department of Insurance:

North Carolina Insurance Commissioner Mike Causey and Attorney General Jeff Jackson have co-authored a letter to the state's Pharmacy Benefits Managers (PBMs) informing them of the new SCRIPT Act.

The SCRIPT Act, passed into law by the General Assembly in 2025, bolsters and expands the legal and regulatory framework and enforcement authority of the N.C. Department of Insurance over PBMs. The Act also strengthens the Department of Justice's ability to investigate PBMs and, if appropriate, pursue legal action against deceptive or anti-competitive PBM practices.

A PBM is an entity who contracts with a pharmacy on behalf of an insurer or third-party administrator to administer or manage prescription drug benefits. This includes negotiating rebates with manufacturers for drugs, processing claims for prescription drugs or medical supplies or providing retail network management for pharmacies or pharmacists, and paying pharmacies or pharmacists for prescription drugs or medical supplies.

"The NCDOI and NCDOJ are focused on promoting a robust, transparent and stable insurance market while also ensuring the safety and fair treatment of North Carolin consumers," Commissioner Causey and Attorney General Jackson say in their letter. "North Carolina's SCRIPT Act represents a shift toward PBM transparency, accountability and consumer protections.

Commissioner Causey and Attorney General Jackson conclude: "The NCDOI and NCDOJ will uphold the legislative mandate of the General Assembly and, where warranted, will pursue all available remedies under law."

The letter reminds PBMs of certain consumer and pharmacy protections in the SCRIPT Act:

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PBMs must allow any willing pharmacy to participate in their networks.

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PBMs cannot require that a consumer purchase prescription drugs exclusively through a mail-order pharmacy.

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Reimbursement rates for an independent pharmacy or a pharmacy in a pharmacy desert must at least cover the acquisition cost for the covered drug, device or service.

North Carolina currently has 23 licensed PBMs, with four more licenses pending.