Senate Bill No. by Senator Harris seeks to regulate pharmacy benefit managers (PBMs) in Louisiana by amending existing laws and introducing new provisions aimed at enhancing transparency and accountability. The bill prohibits spread pricing, which is defined as any amount charged by a PBM that exceeds what is paid to the pharmacy for dispensing a prescription drug, minus a management fee. It also introduces new definitions related to pharmacy benefit management services, such as "Effective Rate Pricing" and "Pharmacy Benefit Management Fee." PBMs are required to negotiate but cannot retain rebates and fees, ensuring their income is derived solely from management fees for services provided to insurers or health plans.

Additionally, the bill grants the commissioner of insurance and health plans the right to conduct annual audits of PBMs, requiring them to provide detailed information regarding reimbursements and rebates. Contracts between PBMs and insurers or health plans entered into after January 1, 2026, must specify all forms of revenue and acknowledge that spread pricing is prohibited. The legislation also reinforces the prohibition against patient steering to pharmacies where the PBM has an ownership interest, ensuring patients are informed of their right to choose any pharmacy without facing retaliation. Violations of these provisions can result in civil monetary penalties, further promoting accountability in the operations of pharmacy benefit managers in the state.

Statutes affected:
SB194 Original: 22:2(A), 22:1867(A), 40:2870(A)(4), 22:1856(F)