1. The Authority shall adopt regulations establishing: (a) The criteria that a pharmacy benefit manager must meet in order to be eligible to enter into a contract with the Authority pursuant to NRS 422.4053 to serve as the state pharmacy benefit manager. (b) The methodology for reimbursement to pharmacies, other than those pharmacies described in paragraph (c), for providing benefits under a contract entered into pursuant to subsection 1 of NRS 422.4053 or paragraph (a) of subsection 2 of NRS 422.4053 . (c) The methodology for reimbursement to pharmacies owned by a health care facility that is registered as a covered entity pursuant to 42 U.S.C. 256b under a contract entered into pursuant to subsection 1 of NRS 422.4053 or paragraph (a) of subsection 2 of NRS 422.4053 . (d) Dispensing fees paid to pharmacies and pharmacists for providing benefits under a contract entered into pursuant to subsection 1 of NRS 422.4053 or paragraph (a) of subsection 2 of NRS 422.4053 . In establishing those dispensing fees, the Authority may consider applicable guidance promulgated by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services. (e) A requirement that providers must submit to the Authority or state pharmacy benefit manager data from claims, as prescribed by the Authority, relating to the actual acquisition costs of drugs purchased by the providers from pharmacies owned by health care facilities that are registered as covered entities pursuant to 42 U.S.C. 256b. 2. To the extent authorized by federal law, the dispensing fees established pursuant to paragraph (d) of subsection 1 may vary by pharmacy type, including, without limitation, rural and independently owned pharmacies, pharmacies owned by a corporation operating in multiple states and pharmacies owned by a health care facility that is registered as a covered entity pursuant to 42 U.S.C. 256b. 3. To the extent practicable, the methodology for reimbursement established pursuant to paragraph (b) of subsection 1 must: (a) Generate the maximum amount of savings for the State with respect to the cost of prescription drugs; (b) Provide rates of reimbursement for drugs which are based on the actual cost of acquiring a drug, to the extent that doing so would result in a reduction of expenditures on prescription drugs by the Authority; and (c) Utilize the Nevada Average Acquisition Cost price benchmark for the purposes set forth in paragraph (b), if established pursuant to subsection 4. 4. Except as otherwise provided in this subsection, the Authority shall establish a pricing benchmark to be known as Nevada Average Acquisition Cost to measure the average, actual cost of prescription drugs purchased by pharmacies and other providers in this State directly from manufacturers and wholesalers of prescription drugs or from any other sources. The Authority shall establish the Nevada Average Acquisition Cost only if, in the determination of the Authority, the development of the benchmark would result in a reduction of spending on prescription drugs by the Authority or otherwise result in a net reduction of expenditures by the State. To facilitate the establishment of the Nevada Average Acquisition Cost price benchmark, the Authority may: (a) Establish a survey that must be completed periodically by pharmacies and other providers who purchase prescription drugs; (b) Utilize any data provided to the Authority by the state pharmacy benefit manager or a health management organization with which the Authority has contracted pursuant to NRS 422.4053 ; (c) Utilize any other data which is accessible to the Authority, including, without limitation, data furnished to the Authority by providers; (d) Utilize methodologies similar to those established by the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services with respect to the National Average Acquisition Cost pricing benchmark; and (e) Adopt such regulations as may otherwise be necessary to carry out the purposes of this section. 5. On or before February 1 of each odd-numbered year occurring after the establishment of the Nevada Average Acquisition Cost price benchmark, if established, the Authority shall: (a) Compile a report concerning the actual or estimated savings generated for the State during the immediately preceding two calendar years from the establishment and utilization of the Nevada Average Acquisition Cost price benchmark; and (b) Submit the report compiled pursuant to paragraph (a) to the Director of the Legislative Counsel Bureau for transmittal to the next regular session of the Legislature. 6. As used in this section: (a) Actual acquisition cost has the meaning ascribed to it in 42 C.F.R. 447.502. (b) Provider means a person or entity who participates in Medicaid as a provider of goods or services.
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