This bill amends various sections of the Louisiana Revised Statutes concerning pharmacy benefit managers (PBMs) to enhance transparency and fairness in the reimbursement process for pharmacists and pharmacies. Key provisions include the prohibition of rebate retention by PBMs, ensuring that all rebates from drug manufacturers are passed on to plan sponsors as shared savings. The bill mandates that PBMs reimburse local pharmacies at least at the acquisition cost for covered drugs and establishes an appeals process for pharmacists to contest claim payment errors. Additionally, it requires PBMs to disclose all fees in their contracts and mandates annual compliance certification to the commissioner of insurance.

The legislation also introduces new regulations for PBMs, including the requirement for annual transparency reports detailing financial metrics such as total rebates and administrative fees. It creates a Pharmacy Benefit Manager Enforcement Fund to support enforcement activities and allows the attorney general to investigate violations. The bill establishes a monitoring advisory council within the Department of Insurance to oversee the implementation of these regulations and introduces prohibitions on practices like effective rate pricing and spread pricing without proper notice. Enforcement of the new provisions will begin on January 1, 2027, following the governor's signature or the designated period for bills to become law without a signature.

Statutes affected:
HB264 Original: 22:1(A)
HB264 Engrossed: 22:1(A), 44:1(B)(11)
HB264 Reengrossed: 22:1(A), 44:1(B)(11)
HB264 Enrolled: 40:2869(A), 40:2870(A)(4), 44:1(B)(11), 22:3(E), 40:2870(A)(5)
HB264 Act 474: 40:2869(A), 40:2870(A)(4), 44:1(B)(11), 22:3(E), 40:2870(A)(5)