House Bill No. 919 aims to enhance the regulation of pharmacy benefit managers (PBMs) in Louisiana by establishing specific requirements for their operations and financial practices. The bill mandates that PBMs reimburse independent pharmacies and pharmacists for under-reimbursed dispensing fees, with the PBMs bearing all associated costs and not passing them onto plans, members, or pharmacies. Additionally, it prohibits PBMs from reimbursing amounts below the most recent National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee, or the wholesale acquisition cost plus the state dispensing fee if NADAC is unavailable. The bill also requires PBMs to disclose information about foreign subsidiaries in their annual transparency reports.

Furthermore, the bill strengthens the fiduciary duties of PBMs, requiring them to act in good faith and in the best interests of beneficiaries and contracted entities. It specifies that PBMs must disclose any conflicts of interest and pass through any volume-based payments received from drug sales to covered entities. The legislation modifies existing law to allow for a cause of action against PBMs for failing to meet these duties, thereby enhancing accountability. The provisions of the bill are set to be retroactive to January 1, 2026, ensuring that the new regulations apply to past transactions as well.

Statutes affected:
HB919 Original:
HB919 Engrossed:
HB919 Reengrossed: