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Bill > HB1125
MS HB1125
MS HB1125Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.
summary
Introduced
01/20/2025
01/20/2025
In Committee
01/20/2025
01/20/2025
Crossed Over
Passed
Dead
02/04/2025
02/04/2025
Introduced Session
2025 Regular Session
Bill Summary
An Act To Prohibit Health Insurers And Pharmacy Benefit Managers From Requiring Covered Individuals To Purchase Or Otherwise Obtain Pharmacy Services Exclusively Through A Pharmacy In Which The Health Insurer Or Pharmacy Benefits Manager Has An Ownership Interest; To Prohibit Health Insurers And Pharmacy Benefit Managers From Offering Or Implementing Health Benefit Plan Designs That Increase Plan Or Patient Costs For Pharmacy Services If The Covered Individual Chooses Not To Use A Pharmacy In Which The Health Insurer Or Pharmacy Benefits Manager Has An Ownership Interest For Those Pharmacy Services; To Prohibit Health Insurers And Pharmacy Benefit Managers From Reimbursing A Pharmacy Or Pharmacist For Covered Pharmacy Services An Amount Less Than The Amount That The Health Insurer Or Pharmacy Benefits Manager Reimburses A Pharmacy In Which The Health Insurer Or Pharmacy Benefits Manager Has An Ownership Interest For Providing The Same Covered Services; To Prohibit Health Insurers And Pharmacy Benefit Managers From Denying A Pharmacy The Opportunity To Participate In Any Pharmacy Network At Preferred Participation Status If The Pharmacy Is Willing To Accept The Terms And Conditions That The Health Insurer Or Pharmacy Benefit Manager Has Established For Other Pharmacies As A Condition Of Preferred Network Participation Status; To Bring Forward Section 83-9-6, Mississippi Code Of 1972, Which Provides For Freedom Of Choice For Pharmacy Services, For The Purpose Of Possible Amendment; And For Related Purposes.
AI Summary
This bill aims to prevent health insurers and pharmacy benefit managers (PBMs) from unfairly steering patients towards pharmacies in which they have an ownership interest. Specifically, the bill prohibits these entities from requiring covered individuals to exclusively obtain pharmacy services from their own pharmacies as a condition of payment or reimbursement. The legislation also bars insurers and PBMs from implementing benefit plan designs that increase costs for patients who choose to use pharmacies outside of the insurer's or PBM's ownership. Additionally, the bill ensures that pharmacies are reimbursed equally regardless of ownership, and prevents insurers from denying a pharmacy preferred network participation status if the pharmacy is willing to accept the same terms as other pharmacies. Key terms are defined in the bill, including "covered individual" (a policyholder or plan participant) and "health benefit plan" (any entity that provides reimbursement for pharmacy services). The bill builds upon existing Mississippi law protecting patient choice in pharmacy services and is set to take effect on July 1, 2025, with the goal of promoting fair competition and giving patients more flexibility in choosing where they obtain their prescription medications.
Committee Categories
Government Affairs
Sponsors (1)
Last Action
Died In Committee (on 02/04/2025)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://billstatus.ls.state.ms.us/2025/pdf/history/HB/HB1125.xml |
| BillText | https://billstatus.ls.state.ms.us/documents/2025/html/HB/1100-1199/HB1125IN.htm |
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