Senate Bill No. by Senator Harris aims to enhance the regulation of pharmacy benefit managers (PBMs) in Louisiana by introducing new provisions and amending existing laws. The bill establishes clear definitions for key terms such as "enrollee," "healthcare service," and "pharmacy benefit management service," while mandating that PBMs act in good faith towards enrollees, health plans, and providers. It emphasizes transparency by requiring PBMs to disclose conflicts of interest and service charges, and it allows individuals harmed by PBM violations to pursue civil actions. Additionally, the bill outlines compensation structures, stating that PBMs may negotiate fees but cannot retain rebates or fees from drug manufacturers, and it requires annual compliance certification and audits by the commissioner.

The legislation also reinforces the responsibilities of PBMs towards health insurance issuers and enrollees, mandating accurate information certification and protecting proprietary data related to drug pricing from public disclosure. It imposes civil monetary penalties for violations, with fines capped at $1,000 per claim, and includes new definitions relevant to PBM operations. The bill repeals R.S. 22:1868.1 and introduces a new section (R.S. 22:1867.1) to strengthen the regulatory framework governing PBMs, with an effective date set for August 1, 2026. Overall, the bill seeks to improve accountability and transparency in the pharmacy benefit management sector, ultimately benefiting consumers and healthcare providers.

Statutes affected:
SB337 Original: 44:1(B)(11)