This bill addresses regulations concerning pharmacy benefits managers (PBMs), pharmacies, and prescription drugs in Iowa. It introduces several new definitions, including "pass-through pricing," which ensures that payments made by third-party payors to PBMs match what PBMs pay to pharmacies. The bill also defines "pharmacy desert" as areas with limited pharmacy access and "specialty drug" as medications requiring special handling or administration. Additionally, it mandates that 100% of rebates received by PBMs be passed on to health carriers or employer plan sponsors to help reduce premiums.

Furthermore, the bill prohibits PBMs from requiring covered individuals to exclusively use mail order pharmacies for prescription services, except for specialty drugs. It establishes a professional dispensing fee of $3 for prescriptions filled at smaller pharmacies and those located in pharmacy deserts. Lastly, it prohibits the practice of spread pricing in contracts between PBMs and third-party payors, effective for contracts executed or renewed after July 1, 2025, for prescription drug benefits starting January 1, 2026.

Statutes affected:
Introduced: 510B.1, 510B.8, 510B.8B