House Bill No. by Representative Turner seeks to enhance the regulation of pharmacy benefit managers (PBMs) in Louisiana by amending existing laws and introducing new provisions. The bill revises the definition of "pharmacy benefit manager" to include any entity managing pharmacy benefits and mandates that PBMs reimburse pharmacies based on the National Average Drug Acquisition Cost (NADAC) plus a dispensing fee aligned with the Louisiana Medicaid program. It also prohibits PBMs from retaining any portion of manufacturer rebates and requires full disclosure of their income sources. Additionally, the legislation establishes requirements for client agreements, compelling PBMs to provide detailed claims-level prescription drug pricing data and reimbursement information to health benefit plans, along with penalties for non-compliance.

Moreover, the bill amends procurement procedures for PBM services, requiring the division of administration to utilize a reverse auction process for procurement and to secure a technology platform for this purpose. It also repeals a previous act from 2025 and sets an implementation date of October 1, 2026, while becoming effective upon the governor's signature or the expiration of the time for gubernatorial action. Overall, the legislation aims to improve transparency and accountability in the pharmacy benefit management sector, ensuring fair compensation for pharmacies and clear information for clients regarding PBM operations.

Statutes affected:
HB938 Original: 22:1863(11), 39:1(D)(1), 39:1(D)(3)