2021 House Bill 4351 / 2022 Public Act 12

Restrict hospitals and insurers from 'gaming' mandated-Medicaid drug discounts

Introduced in the House

Feb. 24, 2021

Introduced by Rep. Karen Whitsett (D-9)

To impose new rules, restrictions and disclosure requirements on health insurers and pharmacy benefit managers selling and marketing prescription drugs to hospitals and clinics that federal rules make eligible for discounts due to treating above-average numbers of Medicaid patients. These providers are not required to pass the savings along to patients. Among other changes the bill would prohibit insurers from requiring patient co-payments for a drug that are higher than the medical provider's cost.

Referred to the Committee on Health Policy

March 11, 2021

Reported without amendment

With the recommendation that the substitute (H-3) be adopted and that the bill then pass.

March 24, 2021

Passed in the House 106 to 1 (details)

Received in the Senate

March 25, 2021

Referred to the Committee on Health Policy and Human Services

Feb. 1, 2022

Reported without amendment

With the recommendation that the bill pass.

Feb. 16, 2022

Passed in the Senate 38 to 0 (details)

To impose new rules, restrictions and disclosure requirements on health insurers and pharmacy benefit managers selling and marketing prescription drugs to hospitals and clinics that federal rules make eligible for discounts due to treating above-average numbers of Medicaid patients. These providers are not required to pass the savings along to patients. Among other changes the bill would prohibit insurers from requiring patient co-payments for a drug that are higher than the medical provider's cost.

Received in the House

Feb. 16, 2022

Passed in the House 104 to 1 (details)

To concur with the Senate-passed version of the bill.

Signed by Gov. Gretchen Whitmer

Feb. 23, 2022