Senate Bill No. 381, introduced by Senator Bass, aims to regulate pharmacy benefit managers (PBMs) in Louisiana by amending existing laws and enacting new provisions. The bill prohibits PBMs from obtaining rebates on brand-name drugs in exchange for not including generic drugs on their formularies. It also establishes that PBMs must pass through all negotiated rebates from drug manufacturers to plan sponsors, ensuring that these savings are reflected in lower premiums or reduced cost-sharing for insured individuals. Additionally, the bill allows pharmacies to submit consolidated appeals for multiple similar claims regarding maximum allowable costs.

The legislation further mandates that when a PBM revises its formulary, it must provide a 60-day continuity-of-care period during which affected drugs remain available at the same cost. It prohibits PBMs from requiring insured individuals to use drugs from affiliated manufacturers when generically equivalent options are available, and it prevents the removal of drugs from the formulary during a policy year, with specific exceptions. The bill also restricts PBMs from reclassifying drugs to more expensive tiers or increasing cost-sharing during the policy year, while still allowing for the addition of new drugs to the formulary. The bill will take effect upon the governor's signature or after the designated time for gubernatorial action.

Statutes affected:
SB381 Original: 22:1865(A), 22:1(A)