Substitute House Bill No. 7192, also known as Public Act No. 25-167, aims to enhance the accountability and transparency of pharmacy benefits managers (PBMs) and health carriers, with several key provisions set to take effect between October 1, 2025, and January 1, 2026. The bill requires PBMs to act in good faith and disclose any conflicts of interest, while also mandating that they offer health plans the option to be charged the same price for prescription drugs as pharmacies. It repeals existing provisions that penalized pharmacists for disclosing medication costs to patients. Additionally, the bill establishes a task force to study emergency preparedness for prescription drug shortages and requires the Insurance Commissioner to report annually on pricing and profits between health carriers and PBMs.

The legislation also introduces a Canadian prescription drug importation program, allowing wholesalers to import non-controlled drugs from Canada, with strict safety and quality requirements. It mandates the Department of Administrative Services to negotiate bulk drug prices for state agencies and allows these agencies to form compacts with other states to enhance their negotiating power. An Advisory Council on Pharmaceutical Procurement will provide guidance on these negotiations, and the Commissioner of Social Services is tasked with seeking authorization for lower-cost generic drugs for specific health conditions. The bill includes new legal language regarding the roles of involved agencies and the establishment of the advisory council, while deleting conflicting provisions from current law.

Statutes affected:
Raised Bill:
HS Joint Favorable:
File No. 414:
INS Joint Favorable:
APP Joint Favorable Substitute:
File No. 916:
Public Act No. 25-167: