House Bill 1959, known as the "Freedom, Access, and Integrity in Registered Pharmacy (FAIR Rx) Act," seeks to amend Tennessee law to address conflicts of interest related to pharmacy benefits managers (PBMs) owning or controlling pharmacies. Starting January 1, 2027, the bill prohibits PBMs from acquiring or controlling pharmacy licenses, thereby separating financial interests from patient care decisions. It also requires pharmacy license applicants to disclose ownership and control information to the Tennessee Board of Pharmacy, with penalties for non-compliance. The act emphasizes maintaining independent pharmacy access, particularly in underserved areas, and mandates the Board of Pharmacy to create rules for implementation.

Additionally, the act establishes regulations regarding ownership and operation of pharmacies and health insurance issuers, effective July 1, 2028. It prohibits any entity from owning more than five percent of a pharmacy or health insurance issuer and clarifies that hospital pharmacies are not considered PBMs. Pharmacies affiliated with PBMs and health insurance issuers can continue operations until December 31, 2028, if they are pursuing a sale to an unaffiliated entity. The attorney general is granted enforcement authority, and civil penalties are established for violations. The act also includes provisions for severability and a process for aggrieved parties to request hearings, ensuring that the remaining sections remain enforceable if any part is invalidated.