The proposed General Assembly Substitute Bill No. 6870 establishes a Canadian prescription drug importation program aimed at reducing prescription drug costs for patients. Effective July 1, 2025, the bill mandates the Commissioner of Consumer Protection to hire a consultant to assess the program's feasibility, with a report due by October 1, 2027. If feasible, the Commissioner may seek federal approval to import prescription drugs from Canada, ensuring compliance with safety and effectiveness standards. Participating wholesalers will be allowed to import certain prescription drugs, excluding controlled substances, and must adhere to track-and-trace requirements to ensure drug safety. The bill also introduces provisions for testing imported drugs for authenticity and degradation, maintaining records for three years, and grants the Commissioner emergency powers to address violations.

Additionally, the bill introduces regulations to control prescription drug pricing, prohibiting pharmaceutical manufacturers and wholesale distributors from selling identified drugs above a defined "reference price" starting January 1, 2026. Price increases are only permitted if a drug is deemed in shortage by the federal Secretary of Health and Human Services. The legislation establishes civil penalties for violations, mandates annual statements from manufacturers and distributors, and allows aggrieved parties to appeal decisions. It also outlines the process for collecting unpaid civil penalties and prohibits entities from withdrawing drugs to evade penalties without prior notice. Furthermore, health insurers must credit insured individuals for out-of-pocket expenses for out-of-network prescription drugs, enhancing affordability and transparency in healthcare access.