HB 2225: PHARMACY BENEFIT MANAGERS; PRESCRIPTION DRUG BENEFIT PLANS; PROVIDERS; BENEFICIARIES; COST SHARING; DEDUCTIBLES; REIMBURSEMENT; PASS-THROUGH PRICING; SPREAD PRICING
- Session Year: 2025-2026
- House: House
- Latest Version Date: 2026-01-26
Current Status:
In Progress
(2026-01-30: Referred to HLT, CPC, referral sheet 5)
Introduced
In Committee
First Chamber
In Committee
Second Chamber
Final Decking
Enacted
Prohibits
discrimination against a pharmacy or pharmacist with respect to participation,
referral, reimbursement of a covered service, or indemnification. Establishes beneficiary cost sharing and
deductible requirements for prescription drugs.
Establishes minimum rates for which pharmacy benefit managers are to
reimburse pharmacies for dispensing prescription drugs. For prescription drug benefit plans executed,
amended, adjusted, or renewed on or after 7/1/2027, requires a pharmacy benefit
manager to use pass-through pricing, or may alternatively use spread pricing if
any savings realized by the pharmacy benefit manager are passed on.