Health & Saf. Code, § 1385.004 · Article 6.1. Pharmacy Benefit Managers
Health & Saf. Code, § 1385.004
Text — As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
(a) A health care service plan that contracts with a pharmacy benefit manager for management of any or all of its prescription drug coverage shall require the pharmacy benefit manager to do all of the following:
(1) Comply with the provisions of Section 1385.003.
(2) Register with the department pursuant to the requirements of this article, or, if licensure of the pharmacy benefit manager is required pursuant to this article, obtain a license and keep it in good standing with the department.
(3) Exercise good faith and fair dealing in the performance of its contractual duties to a health care service plan.
(4) Comply with the requirements of Chapter 9.5 (commencing with Section 4430) of Division 2 of the Business and Professions Code, as applicable.
(5) Inform all pharmacists under contract with or subject to contracts with the pharmacy benefit manager of the pharmacist’s rights to submit complaints to the department under Section 1371.39 and of the pharmacist’s rights as a provider under Section 1375.7.
(b) Contracts issued, amended, or renewed on or after January 1, 2026, between a health care service plan and a pharmacy benefit manager shall require the pharmacy benefit manager to submit to the Department of Health Care Access and Information all information required to be reported pursuant to Chapter 8.5 (commencing with Section 127671) of Part 2 of Division 107.
(c) A pharmacy benefit manager shall notify a health care service plan in writing of any activity, policy, or practice of the pharmacy benefit manager that directly or indirectly presents a conflict of interest that interferes with the discharge of the pharmacy benefit manager’s duty to the health care service plan to exercise good faith and fair dealing in the performance of its contractual duties pursuant to subdivision (a).
Notes and commentary — not statutory text
History
Amended by Stats. 2025, Ch. 21, Sec. 13. (AB 116) Effective June 30, 2025.
Source of truth
- Edition
- As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
- Official file
- https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=1385.004.
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- sha256 82138b77ffaf9a383f3ef57008407374b810072ae505124cd10521ea659c6ea4
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- compose_ca.py 2026-10-22: the Legislative Counsel's CAML content files read by a tokenizer (caml_readers.reader_a); an independent xml.etree reading (caml_readers.reader_b) agrees on every section
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Business and Professions Code
Health and Safety Code
- Health & Saf. Code, § 1371.39Printed as Section 1371.39
- Health & Saf. Code, § 1375.7Printed as Section 1375.7
- Health & Saf. Code, § 1385.003Printed as Section 1385.003
- Health & Saf. Code, div. 107, pt. 2, ch. 8.5Health Care Payments Data ProgramPrinted as Chapter 8.5 (commencing with Section 127671) of Part 2 of Division 107
Cited by 2 provisions
Provisions in this library whose text cites Health & Saf. Code, § 1385.004. Each shows the citation as that text prints it.
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