Bill > HB830

Introduced Session

Pharmacy benefits managers; requirements; scope; report. Requires all health insurance carriers to use the pass-through pricing model and may limit a pharmacy benefits manager from deriving income from pharmacy benefits management services provided to a carrier except for income derived from a pharmacy benefits management fee. The bill prohibits a pharmacy benefits manager from (i) reversing and or resubmitting the claim of a pharmacist or pharmacy without meeting certain requirements, (ii) reducing any payment to a pharmacist or pharmacy to an effective rate of reimbursement, or (iii) retroactively denying or reducing a claim or aggregate of claims except under certain circumstances. The bill requires the State Corporation Commission (the Commission) to examine the practice of carriers or pharmacy benefits managers requiring or inducing covered individuals to utilize pharmacy services at an affiliated pharmacy. The Commission is required to report its findings and recommendations to the General Assembly by December 1, 2027. Certain provisions of the bill have a delayed effective date of July 1, 2027. This bill is identical to SB 669.

AI Summary

Committee Categories

Katrina Callsen (D)*,  Kimberly Adams (D),  Jessica Anderson (D),  Bonita Anthony (D),  Elizabeth Bennett-Parker (D),  Gretchen Bulova (D),  Kacey Carnegie (D),  Stacey Carroll (D),  Nadarius Clark (D),  Nicole Cole (D),  Rae Cousins (D),  Lindsey Dougherty (D),  Mark Downey (D),  Lily Franklin (D),  Margaret Franklin (D),  Elizabeth Guzmán (D),  Phil Hernandez (D),  Karen Keys-Gamarra (D),  Amy Laufer (D),  Fernando Martinez (D),  Adele McClure (D),  Leslie Chambers Mehta (D),  May Nivar (D),  Marcia Price (D),  Sam Rasoul (D),  Charlie Schmidt (D),  Shelly Simonds (D),  Virgil Thornton (D),  Kathy Tran (D),  Howard Wachsmann (R),  Rodney Willett (D), 

Approved by Governor-Chapter 678 (effective 7/1/2026) (on 04/13/2026)

Official Document