This bill amends various sections of the Louisiana Revised Statutes concerning pharmacy benefit managers (PBMs) to improve transparency and fairness in the pharmacy reimbursement process. 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 local pharmacies be reimbursed at least at the acquisition cost for covered drugs, devices, or services, and establishes an appeals process for pharmacists to contest claim payment errors. Additionally, PBMs are required to disclose all management fees in their contracts with insurers or health plans, and they must submit an annual transparency report detailing financial metrics, which will be published by the Department of Insurance.

The legislation also introduces new requirements for PBMs, including an annual certification of compliance with the bill's provisions, signed by the CEO or CFO, and subject to audit. Violations will be considered unfair or deceptive acts, allowing for enforcement actions by the commissioner of insurance. The bill creates a Pharmacy Benefit Manager Enforcement Fund to support these actions and grants the attorney general the authority to investigate violations. Furthermore, it establishes an advisory council funded through licensing fees from PBMs, which will oversee the implementation of the new regulations. The bill aims to protect pharmacists and patients from unfair practices while ensuring that patients benefit from negotiated rebates and lower drug costs. Enforcement of the new provisions will begin on January 1, 2027.

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)