Bill

Bill > HB1672


MS HB1672

MS HB1672
Pharmacy Benefit Prompt Pay Act; revise.


summary

Introduced
01/19/2026
In Committee
01/19/2026
Crossed Over
Passed
Dead
02/03/2026

Introduced Session

2026 Regular Session

Bill Summary

An Act To Revise The Pharmacy Benefit Prompt Pay Act; To Amend Section 73-21-151, Mississippi Code Of 1972, To Reference New Sections Added To The Pharmacy Benefit Prompt Pay Act; To Amend Section 73-21-153, Mississippi Code Of 1972, To Define New Terms And Revise The Definitions Of Certain Existing Terms; To Amend Section 73-21-155, Mississippi Code Of 1972, To Revise The Reimbursement Amount From Pharmacy Benefit Managers And Pharmacy Services Administrative Organizations (psaos) Payable To Pharmacies; To Require Pharmacy Benefit Managers To Give Pharmacists Reasons For Denying A Claim Within Seven Days Of Receiving An Electronic Claim; To Amend Section 73-21-156, Mississippi Code Of 1972, To Delete Provisions Authorizing Pharmacy Benefit Managers From Using Maximum Allowable Cost Lists; To Revise The Administrative Appeals Process Pharmacy Benefit Managers Must Make Available To Pharmacies To Challenge Reimbursements; To Amend Section 73-21-157, Mississippi Code Of 1972, To Require Psaos To Be Licensed By The State Board Of Pharmacy; To Require Pharmacy Benefit Managers And Psaos To Renew Licenses Annually; To Revise The Financial Documents That Must Be Submitted To The Board With An Application For A License Or License Renewal; To Create New Section 73-21-158, Mississippi Code Of 1972, To Prohibit The Use Of Spread Pricing By Pharmacy Benefit Managers; To Bring Forward Section 73-21-159, Mississippi Code Of 1972, Which Relates To Financial Examinations Of Pharmacy Benefit Managers, For Purposes Of Possible Amendment; To Amend Section 73-21-161, Mississippi Code Of 1972, To Prohibit Steering By Pharmacy Benefit Managers; To Create New Section 73-21-162, Mississippi Code Of 1972, To Prohibit Retaliation Against Pharmacists By Pharmacy Benefit Managers, Pharmacy Benefit Manager Affiliates And Psaos; To Amend Section 73-21-163, Mississippi Code Of 1972, To Revise Provisions Relating To Investigations And Audits Of Pharmacy Benefit Managers Conducted By The Board; To Create New Section 73-21-165, Mississippi Code Of 1972, To Require Pharmacy Benefit Managers To Submit Certain Annual Reports To The Board; To Create New Section 73-21-167, Mississippi Code Of 1972, To Create The Mississippi Specialty Drug Committee; To Create New Section 73-21-211, Mississippi Code Of 1972, To Designate Certain Newly Created Statutes As The Pharmacy Fair Competition Act; To Create New Section 73-21-213, Mississippi Code Of 1972, To Declare Certain Legislative Findings Relating To The Distribution And Retail Sale Of Pharmaceutical Drugs And The Public Necessity To Regulate And License Certain Pharmaceutical Industries; To Create New Section 73-15-215, Mississippi Code Of 1972, To Prohibit Pharmacy Benefit Managers From Holding A Pharmacy Permit For The Retail Sale Of Drugs; To Authorize The Board To Issue Limited Use Permits For The Sale Of Rare Drugs Under Certain Circumstances; To Create New Section 73-21-217, Mississippi Code Of 1972, To Require The Board To Assess Each Active Retail Pharmacy Permit To Determine If The Permit Holder Is In Violation Of Section 73-21-215, Mississippi Code Of 1972; To Amend Section 25-15-301, Mississippi Code Of 1972, To Authorize The State And School Employees Life And Health Insurance Plan To Contract For The Management Of Pharmacy Benefits; To Require The Executive Director Of The State Board Of Pharmacy To Be A Member Of The Evaluation Committee When Considering Proposals For Such Administration; To Require A Pharmacy Benefits Manager For The State Health Plan To Comply With The Provisions Of The Pharmacy Benefit Prompt Pay Act; To Amend Section 25-15-303, Mississippi Code Of 1972, To Add The Executive Director Of The State Board Of Pharmacy To The Membership Of The State And School Employees Health Insurance Management Board; And For Related Purposes.

AI Summary

This bill, known as the Pharmacy Benefit Prompt Pay Act and the Pharmacy Fair Competition Act, significantly revises regulations for Pharmacy Benefit Managers (PBMs) and Pharmacy Services Administrative Organizations (PSAOs) in Mississippi. Key provisions include requiring PBMs to provide pharmacists with reasons for denying a claim within seven days of receiving an electronic claim, prohibiting PBMs from using Maximum Allowable Cost (MAC) lists to set reimbursement rates and instead mandating reimbursement at no less than the greater of what the PBM pays its affiliates or what the Mississippi Division of Medicaid pays, and requiring PBMs and PSAOs to be licensed annually by the State Board of Pharmacy, submitting financial documents for review. The bill also introduces new definitions for terms like "clean claim," "network pharmacy," and "spread pricing," and explicitly prohibits PBMs from engaging in spread pricing, which is defined as charging more than the ingredient cost plus dispensing fee. Furthermore, it establishes a process for pharmacies to appeal reimbursements, prohibits PBMs from retaliating against pharmacists or pharmacies for exercising their rights, and requires PBMs to disclose certain financial information and rebate data to the Board of Pharmacy and plan sponsors. The bill also creates the Mississippi Specialty Drug Committee to develop a list of specialty drugs and prohibits PBMs from holding pharmacy permits for retail drug sales, with provisions for limited use permits for rare drugs. Finally, it amends laws related to the State and School Employees Life and Health Insurance Plan to include the Executive Director of the State Board of Pharmacy on the evaluation committee for pharmacy benefit management contracts and to ensure that pharmacy benefit managers for the state health plan comply with these new regulations.

Committee Categories

Government Affairs

Sponsors (3)

Last Action

Died In Committee (on 02/03/2026)

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