An Act to Prohibit Pharmacy Benefits Managers from Imposing
Maine Legislature, Session 132, LD 1580
Committee: Health Coverage, Insurance and Financial Services
Sponsors: NUTTING
Amends: 24-A MRSA §4350-F

Legislative Document
No. 1580
H.P. 1038
House of Representatives, April 10, 2025
An Act to Prohibit Pharmacy Benefits Managers from Imposing 
Certain Fees and Pricing
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative NUTTING of Oakland.
Cosponsored by Representatives: BRIDGEO of Augusta, CLUCHEY of Bowdoinham, 
COLLAMORE of Pittsfield, DUCHARME of Madison, FOLEY of Wells, HENDERSON of 
Rumford, MORRIS of Turner, OLSEN of Raymond.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §4350-F is enacted to read:
§4350-F.  Spread pricing prohibition and fairness in pharmacy benefits management 
fees
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A. "Pharmacy benefits management fee" means a fee that covers the cost of providing 
one or more pharmacy benefits manager services, as described in section 4347, 
subsection 17, and that does not exceed the value of the service or services actually 
performed by the pharmacy benefits manager.
B. "Rebate" means:  
(1) Negotiated price concessions, including but not limited to base price 
concessions, whether described as a rebate or otherwise;
(2) Reasonable estimates of any price protection rebates and performance-based 
price concessions that may accrue directly or indirectly to the carrier or health plan 
during the coverage year from a manufacturer, dispensing pharmacy or other party 
in connection with the dispensing or administration of a prescription drug; and
(3) Reasonable estimates of any negotiated price concessions, fees and other 
administrative costs that are passed through, or are reasonably anticipated to be 
passed through, to the carrier or health plan and serve to reduce the carrier's or 
health plan's costs.
C. "Spread pricing" means any amount charged or claimed by a pharmacy benefits 
manager in excess of the ingredient cost for a dispensed prescription drug plus the 
dispensing fee paid directly or indirectly to any pharmacy or pharmacist on behalf of 
the health plan, less a pharmacy benefits management fee that conforms with the 
requirements of this section.
2.  No income derived beyond pharmacy benefits manager services fee.  A 
pharmacy benefits manager may not derive income from pharmacy benefits manager 
services, as described in section 4347, subsection 17, provided to a carrier or health plan in 
this State except for income derived from a pharmacy benefits management fee. This 
subsection may not be construed to permit a pharmacy benefits management fee to be 
derived from compensation remitted by or on behalf of a pharmaceutical manufacturer, 
developer or labeler directly or indirectly to a carrier, or to a pharmacy benefits manager 
under contract with a carrier, related to the carrier's prescription drug benefits. The amount 
of any pharmacy benefits management fees must be established in the agreement between 
the pharmacy benefits manager and the carrier or health plan. 
3.  Setting pharmacy benefits management fees; limitations.  The pharmacy benefits 
management fee charged by or paid to a pharmacy benefits manager may not be directly or 
indirectly based or contingent upon: 
A. The acquisition cost or any other price metric of a drug; 
B. The amount of savings, rebates or other fees charged, realized or collected by or 
generated based on the activity of the pharmacy benefits manager; or
C. The amount of premiums, deductibles or other cost sharing or fees charged, realized 
or collected by the pharmacy benefits manager from patients or other persons on behalf 
of a patient.
4.  Spread pricing prohibited.  A pharmacy benefits manager, carrier or health plan 
may not, either directly or through an intermediary, agent or affiliate, engage in, facilitate 
or enter into a contract with another person involving spread pricing in this State. 
5.  Annual certification of compliance.  Annually by December 31st, a pharmacy 
benefits manager operating in the State shall certify to the superintendent that it has fully 
complied with the requirements of this section throughout the prior calendar year. The 
certification must be signed by the chief executive officer or chief financial officer of the 
pharmacy benefits manager. 
6.  Penalty.  Violation of this section is a civil violation for which the superintendent 
may assess a penalty not to exceed $1,000 per violation. This subsection may not be 
construed to preclude the application of any other relevant civil or criminal penalty in state 
or federal law.
SUMMARY
This bill provides that a pharmacy benefits manager may not derive income from 
pharmacy benefits manager services provided to a carrier or health plan in this State except 
for income derived from a pharmacy benefits management fee. The pharmacy benefits 
management fee may not exceed the value of the services actually performed by the 
pharmacy benefits manager. The bill prohibits so-called spread pricing, which, under the 
bill, means amounts charged by a pharmacy benefits manager in excess of the ingredient 
cost for a dispensed prescription drug, the dispensing fee paid to the pharmacy or 
pharmacist and the pharmacy benefits management fee. 
The bill establishes additional requirements related to what costs may not be included 
in the pharmacy benefits management fee. The amount of any pharmacy benefits 
management fees must be established in the agreement between the pharmacy benefits 
manager and the carrier or health plan.
The bill requires that pharmacy benefits managers annually certify to the 
Superintendent of Insurance that they are in compliance with the provisions of the bill. 
The superintendent may assess a civil penalty for violation of these provisions not to 
exceed $1,000 per violation.