Senator Rochelle Winn, sponsor of Senate Bill 316, told the Assembly Committee on Commerce and Labor that the measure addresses how pharmacy benefit managers, or PBMs, handle rebates and discounts and would require the savings to flow to patients. "Too many Nevadans cannot afford their life changing and life saving prescription drugs," Winn said, adding that PBMs have "manipulated the market driving up the costs of drugs and putting smaller pharmacies out of business."

The bill would require PBMs and carriers to pass rebate savings to patients either at the pharmacy counter or by lowering enrollee cost-sharing, establish reporting requirements to the Division of Insurance, and create a statutory duty of care and a fiduciary obligation to prioritize patients over shareholders. Caitlin Cardavani of New Day Nevada, who testified with the sponsor, said the bill is broken into four parts, including strong transparency reporting and rebate pass-through provisions: "This bill will require that 100% of the rebate minus agreed upon fees and other required reimbursements goes to benefit the patient either at the point of sale at the pharmacy counter or through lowering their out of pocket cost sharing obligations with their health insurer."

Supporters — including the Nevada Pharmacy Alliance, the Nevada Society of Dermatology and Dermatologic Surgery, and independent pharmacists — said PBM consolidation has concentrated market power (the sponsor said three PBMs control about 80% of the market) and that rebate structures have not reduced consumer out-of-pocket costs. Several supporters cited Arkansas data that they say showed roughly $400–$500 in annual savings at the pharmacy counter for selected drugs after rebate-pass-through policies were enacted there.

Opponents — including trade groups for PBMs and health plans (PCMA, Nevada Association of Health Plans, AHIP) — said the bill as written could shift administrative costs onto plans and enrollees, raise premiums and out-of-pocket costs, and create legal uncertainty because of the expanded fiduciary language. Paul Young of PCMA warned manufacturers might refuse to pay certain administrative fees if the bill's rebate definition was not carefully limited, which could raise consumer costs. Trey Abney of AHIP said rebate pass-through mandates have been estimated elsewhere to raise premiums and reduce shared savings across enrollees.

Committee counsel and the Division of Insurance answered procedural and technical questions during the hearing. The Division of Insurance described prior fiscal-note activity and said it would need resources to administer the new reporting and enforcement obligations; the sponsor said the bill as amended includes funding and cited an implementation staffing estimate of about four employees and roughly $900,000 to support enforcement and reporting.

After the hearing the committee moved to a work session and voted to advance SB 316 as amended (motion to do pass as amended). The motion passed on a voice vote; the committee chair assigned the floor statement to Assembly member Miller.

The measure explicitly excludes self-insured plans, Medicaid, Public Employees' Benefits (PEB) plans and other ERISA plans from the bill's pass-through requirement, leaving the mandate aimed at for-profit carriers and PBMs, according to sponsor remarks.