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Bill > HB1665


MS HB1665

MS HB1665
Pharmacy Benefit Prompt Pay Act and State Health Insurance Plan; revise.


summary

Introduced
01/19/2026
In Committee
02/13/2026
Crossed Over
02/04/2026
Passed
Dead

Introduced Session

Potential new amendment
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 Create New Section 73-21-154, Mississippi Code Of 1972, To Transfer All Powers And Duties Exercised By The State Board Of Pharmacy Under The Pharmacy Benefit Prompt Pay Act To The Commissioner Of Insurance; 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 To Use 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 Commissioner Of Insurance; To Require Pharmacy Benefit Managers And Psaos To Renew Licenses Annually; To Revise The Financial Documents That Must Be Submitted To The Commissioner With An Application For A License Or License Renewal; To Create New Section 73-21-157.1, Mississippi Code Of 1972, To Create A Special Fund In The State Treasury To Support The Operations Of The Department Of Insurance In The Regulation Of Pharmacy Benefit Managers; To Require The State Fiscal Officer To Transfer Unobligated Funds In The Special Fund Previously Used By The State Board Of Pharmacy For The Regulation Of Pharmacy Benefit Managers To The New Special Fund; To Create New Section 73-21-158, Mississippi Code Of 1972, To Prohibit The Use Of Spread Pricing By Pharmacy Benefit Managers; To Amend Section 73-21-159, Mississippi Code Of 1972, In Conformity To The Provisions Of This Act; 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 Commissioner; To Create New Section 73-21-165, Mississippi Code Of 1972, To Require Drug Manufacturers, Pharmacy Benefit Managers, Psaos And Health Insurers To Submit Certain Annual Reports To The Commissioner; To Create New Section 73-21-167, Mississippi Code Of 1972, To Require Plan Sponsors To Develop Criteria And A List Of Prescription Drugs Designated As Specialty Drugs; To Create New Section 73-21-168, Mississippi Code Of 1972, To Require The Commissioner To Develop A Website To Publish Certain Information Related To This Act; To Create New Section 73-21-169, Mississippi Code Of 1972, To Require Pharmacy Benefit Managers And Psaos To Identify Ownership Affiliation Of Any Kind To The Commissioner; To Amend Sections 73-21-83 And 73-21-91, Mississippi Code Of 1972, In Conformity To The Preceding Provisions; To Amend Section 25-15-301, Mississippi Code Of 1972, To Require The State And School Employees Health Insurance Management Board To Solicit Requests For Proposals For The Administration Of The Plan Or Components Of The Plan Every Two Years; To Authorize The State And School Employees Life And Health Insurance Plan To Contract For The Management Of Pharmacy Benefits; To Require The Commissioner Of Insurance 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 Revise The Membership Of The State And School Employees Health Insurance Management Board; To Create New Section 25-15-305, Mississippi Code Of 1972, To Require The State And School Employees Health Insurance Management Board To Develop A List Of Prescription Drugs That Meet The Criteria Established By The Board For Specialty Drug Designation; To Require The Board To Consult With The Administrators Of The Public Employee Health Plans In The Contiguous States To Determine The Feasibility Of Entering Into A Joint Agreement To Combine Purchasing Power For Pharmaceuticals; To Amend Section 25-15-11, Mississippi Code Of 1972, In Conformity To The Provisions Of This Act; To Bring Forward Sections 25-15-3, 25-15-5, 25-15-7, 25-15-9, 25-15-13, 25-15-14, 25-15-15, 25-15-16, 25-15-17, 25-15-19 And 25-15-23, Mississippi Code Of 1972, Which Relate To The State Employees Life And Health Insurance Plan, For The Purpose Of Possible Amendment; To Bring Forward Sections 41-149-5, 41-151-7 And 73-21-205, Mississippi Code Of 1972, For The Purpose Of Possible Amendment; To Provide For Severability; To Create New Section 73-21-171, Mississippi Code Of 1972, To Provide For The Repeal Of The Pharmacy Benefit Prompt Pay Act; To Create New Section 25-15-307, Mississippi Code Of 1972, To Provide For The Repeal Of Those Sections Relating To The Administration Of The Public Employee Health Plans; And For Related Purposes.

AI Summary

This bill, titled the Pharmacy Benefit Prompt Pay Act and State Health Insurance Plan; revise, significantly reforms the regulation of pharmacy benefit managers (PBMs) and Pharmacy Services Administrative Organizations (PSAO) in Mississippi by transferring regulatory authority from the State Board of Pharmacy to the Commissioner of Insurance, establishing new licensing and renewal requirements for PBMs and PSAOs, and creating a dedicated special fund within the Department of Insurance to support these regulatory operations. Key provisions include mandating that PBMs and PSAOs reimburse pharmacies at a rate no less than the pharmacy's acquisition cost for dispensed drugs, requiring PBMs to provide detailed reasons for claim denials within seven days, prohibiting PBMs from using "spread pricing" (charging more than the cost of the drug plus dispensing fee), and preventing PBMs from engaging in "steering" patients to affiliated pharmacies. The bill also introduces new reporting requirements for drug manufacturers, PBMs, PSAOs, and health insurers, mandates the creation of a public website to disseminate information related to these regulations, and prohibits retaliation by PBMs, their affiliates, and PSAOs against pharmacists. Additionally, it revises the administration of the State and School Employees Health Insurance Plan, requiring more frequent requests for proposals for plan administration and including the Commissioner of Insurance on evaluation committees for pharmacy benefit management proposals, while also requiring PBMs managing benefits for the state plan to comply with the new Pharmacy Benefit Prompt Pay Act. Finally, the bill includes provisions for the repeal of the Pharmacy Benefit Prompt Pay Act and related sections concerning public employee health plan administration on July 1, 2029.

Committee Categories

Government Affairs, Health and Social Services

Sponsors (1)

Last Action

Referred To Public Health and Welfare (on 02/13/2026)

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