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Yes: 343 • No: 43
North CarolinaSB 4792025-2026 SessionSenateWALLET
SCRIPT Act.
Sponsored By: Danny Earl Britt, Jr. (Republican), Amy S. Galey (Republican), Benton G. Sawrey (Republican)
Signed by Governor
COMMERCECOMMUNITY DEVELOPMENTCONSUMER PROTECTIONCONTRACTSCOUNTIESHEALTH SERVICESINSURANCEINSURANCE DEPT
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Bill Overview
Analyzed Economic Effects
14 provisions identified: 11 benefits, 0 costs, 3 mixed.
Lower drug costs at the counter
Beginning January 1, 2027, your insurer must cut your prescription cost at checkout by 90% of the rebates tied to that drug. Insurers must certify each year by January 1 that their plans follow this rule, and violations can be penalized daily. Starting October 1, 2025, pharmacy benefit managers must follow the state’s rules for calculating your out‑of‑pocket costs.
Medicaid managed care pharmacy pay matches fee‑for‑service
Under Medicaid managed care, pharmacy reimbursement for covered outpatient drugs and the dispensing fee uses 100% of the Medicaid fee‑for‑service methods approved by CMS. For retail community claims not using 340B, pay is NADAC plus a professional dispensing fee; 340B claims follow the CMS‑approved State Plan. This rule applies to prepaid plan capitated contracts and expires June 30, 2031.
Fairer network rules for pharmacies
PBMs cannot block a properly licensed pharmacy from joining a retail network on the same terms as similar providers. PBMs cannot charge network participation fees or demand multiple specialty accreditations, and networks must meet Medicare Part D access standards. Starting October 1, 2025, PBM contracts cannot force independent pharmacies or pharmacies in pharmacy deserts to take pay below their drug acquisition cost. PSAOs must give pharmacies copies of the contract terms. The law also defines “specialty drug” and “specialty pharmacy” for these rules.
Fairer pharmacy audits and recoupments
Audits must give at least 14 days’ notice for the first site visit, limit lookback to 24 months, and cap broad audits to the lesser of 0.1% of fills or 50 fills. Pharmacies get at least 30 days to respond, and auditors generally cannot recoup disputed funds until appeals finish; extrapolation is barred except where federal law requires it. Before taking back money, auditors must send a written summary with the total and an approximate date within a seven‑day window and include payment records. Auditors must offer an appeal, and any unproven findings must be dismissed. Contracts must also let PBMs obtain needed information from PSAOs during an audit.
Pharmacy benefit managers must pay fairly
Starting Oct 1, 2025, a pharmacy benefit manager may not pay a pharmacy less than it pays its own affiliate for the same drug or pharmacist service. The comparison is per unit, uses the same generic product identifier, and includes all rebates, fees, and discounts. Breaking this rule is an unfair trade practice and can bring penalties.
PSAOs must be licensed and transparent
PSAOs that negotiate for North Carolina pharmacies must have a state license. PSAOs must disclose who owns or controls them before contracting and notify pharmacies, PBMs, payers, and the Department within 10 days if that changes. They must send pharmacies copies of contracts and payment terms within 10 days, pass through claim remittances in a reasonable time, help with dispute communications, and disclose any deals that require pharmacies to buy from affiliated companies. Noncompliance can trigger $500 per day fines from notice until fixed and can lead to license revocation or nonrenewal.
Stronger buying rights for independent pharmacies
PSAOs cannot force a pharmacy to buy set quantities just to get discounts. PSAOs also may not price drugs for independents based on what the PSAO paid a wholesaler. If a PSAO has ties to a drug or device seller, it cannot require a pharmacy to buy only from that related company.
Drug makers must report big increases
Starting January 1, 2026, by January 31 each year, manufacturers must report any price hike of 15% or more from the prior year for drugs that cost $100 or more for a 30‑day supply. Reports must include acquisition date and price (if the drug was bought, not developed) and the last five years of price changes. This improves visibility into large drug price jumps.
Drug price notices and public portal
Beginning Jan 1, 2026, drug makers must report the price of any new drug within 3 days of sale in the state. If they bought the drug, they must disclose the acquisition date and price within 30 days. The state builds a public portal and, starting Jan 1, 2027, posts yearly lists of the most used, most costly, and fastest‑rising drugs and the top makers by price increases. Manufacturer submissions are treated as trade secrets and kept confidential unless already public. The Secretary may fine makers up to $1,000 per day for late or missing reports, with proceeds to the Civil Penalty and Forfeiture Fund.
Stronger PBM oversight and transparency
PBMs must act in the best interest of insurers, pass through rebates tied to plan funds, and avoid self‑dealing. PBMs are subject to the same prescription‑coverage and unfair‑trade rules as insurers. Starting March 31, 2026, PBMs must file quarterly reports showing, by drug, the spread between what they charge plans and what they pay pharmacies; insurers must post these reports and share them with employers. When an insurer asks, the PBM must share claims and cost data for a specified outpatient drug. Beginning October 1, 2025, the State Plan’s procurement may include equal pay for affiliated and non‑affiliated pharmacies, pharmacy‑of‑choice protections, reporting duties, and other consumer safeguards.
PBM reporting and patient data privacy
PBMs must file yearly reports by May 1 with rebate, spread, fee, and payment data for North Carolina insurers. Starting Oct 1, 2025, these filings are confidential and must not include any insured person’s identifying details. Beginning Oct 1, 2025, PBMs also may not share prescription records with affiliates in ways HIPAA forbids. The Department of Insurance must issue rules to run this part of the law by Oct 1, 2025.
You can choose your pharmacy
Beginning October 1, 2025 (for new, renewed, or amended plans), your plan cannot stop you from using any participating pharmacy or force you to use mail order. Plans cannot steer you with higher copays or lower reimbursements, except they may give monetary advantages to pharmacies in pharmacy deserts or in counties under 20,000 people. Copays and fees must be the same for people in the same plan tier, and a pharmacy’s pay cannot be cut just because you chose it. Insurers must offer identical contract terms to all pharmacies at least 60 days before a restricted network starts, and conflicting plan terms are void. The Commissioner refuses approval of non‑conforming plans, and people and pharmacies can sue to stop violations. Pharmacies cannot waive or discount your copay or coinsurance, and a small shipping fee for mailed prescriptions is allowed if disclosed before delivery. Lock‑in programs allowed under state law are not violations.
Licensing and oversight for pharmacy service groups
Pharmacy services administrative organizations (PSAOs) must be licensed and pay a $200 application fee and a $150 yearly renewal fee. Applications must list contact info, service agent, managers, beneficial owners, and felony‑conviction disclosures. PSAOs must disclose who owns or controls them, update ownership within 10 days of material changes, and file a notice for any material changes to application information. Disclosures must state any ownership or control by groups that provide pharmacy services, drugs, or medical products. PSAO reports to the Department are confidential and must not include insured people’s personal details. Certain PSAO violations are treated as unfair trade practices. The Commissioner must adopt rules to implement these provisions by Oct 1, 2026.
Criminal-fraud audits follow criminal rules
Audits or investigations that allege Medicaid fraud, Medicaid abuse, insurance fraud, or other criminal fraud are not covered by this Part’s audit protections. Those cases proceed under criminal or other applicable authorities instead.
Sponsors & Cosponsors
Sponsors
Danny Earl Britt, Jr.
Republican • Senate
Amy S. Galey
Republican • Senate
Benton G. Sawrey
Republican • Senate
Cosponsors
Buck Newton
Republican • Senate
Lisa S. Barnes
Republican • Senate
Phil Berger
Republican • Senate
Woodson Bradley
Democratic • Senate
Bob Brinson
Republican • Senate
Jim Burgin
Republican • Senate
Jay J. Chaudhuri
Democratic • Senate
David W. Craven, Jr.
Republican • Senate
Warren Daniel
Republican • Senate
Bobby Hanig
Republican • Senate
Ralph Hise
Republican • Senate
Mark Hollo
Republican • Senate
Brent Jackson
Republican • Senate
Steve Jarvis
Republican • Senate
Todd Johnson
Republican • Senate
Michael A. Lazzara
Republican • Senate
Tom McInnis
Republican • Senate
Timothy D. Moffitt
Republican • Senate
Brad Overcash
Republican • Senate
Bill Rabon
Republican • Senate
Norman W. Sanderson
Republican • Senate
Vickie Sawyer
Republican • Senate
Eddie D. Settle
Republican • Senate
Roll Call Votes
House vote • 6/26/2025
SB 479: SCRIPT Act.
Yes: 106 • No: 0 • Other: 10
Senate vote • 6/26/2025
SB 479: SCRIPT Act.
Yes: 42 • No: 0 • Other: 8
Senate vote • 6/19/2025
SB 479: SCRIPT Act.
Yes: 9 • No: 31 • Other: 10
House vote • 6/18/2025
SB 479: SCRIPT Act.
Yes: 96 • No: 12 • Other: 9
Senate vote • 5/7/2025
SB 479: SCRIPT Act.
Yes: 45 • No: 0 • Other: 3
Senate vote • 5/7/2025
SB 479: SCRIPT Act.
Yes: 45 • No: 0 • Other: 3
Actions Timeline
Ch. SL 2025-69
7/9/2025SenateSigned by Gov. 7/9/2025
7/9/2025SenatePres. To Gov. 6/30/2025
6/30/2025SenateRatified
6/30/2025SenateOrdered Enrolled
6/26/2025SenateConf Report Adopted
6/26/2025HouseAdded to Calendar
6/26/2025HouseConf Com Reported
6/26/2025HouseConf Report Adopted
6/26/2025SenatePlaced on Today's Calendar
6/26/2025SenateConf Com Reported
6/26/2025SenateConf Com Appointed
6/23/2025HouseConf Com Appointed
6/19/2025SenateFailed Concur In H Com Sub
6/19/2025SenatePlaced On Cal For 06/19/2025
6/18/2025SenateSpecial Message Received For Concurrence in H Com Sub
6/18/2025SenateSpecial Message Sent To Senate
6/18/2025HousePassed 3rd Reading
6/18/2025HousePassed 2nd Reading
6/18/2025HouseAdded to Calendar
6/18/2025HouseCal Pursuant Rule 36(b)
6/18/2025HouseReptd Fav
6/18/2025HouseRe-ref Com On Rules, Calendar, and Operations of the House
6/17/2025HouseReptd Fav Com Substitute
6/17/2025HouseRe-ref to the Com on Health, if favorable, Rules, Calendar, and Operations of the House
6/16/2025House
Bill Text
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Filed
Latest Edition
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