All Roll Calls
Yes: 132 • No: 98
IowaSF 38391st General Assembly (2025–2026)SenateWALLET
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.
Sponsored By: COMMITTEE ON HEALTH AND HUMAN SERVICES
Signed by Governor
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 6 benefits, 0 costs, 0 mixed.
Prescription payments count toward plan limits
Beginning July 1, 2025, pharmacy benefits managers must count payments made by you or on your behalf toward total cost-sharing. Your prescription payments must also count toward any plan deductible, as provided in your plan’s coverage documents. For qualifying high-deductible plans, the cost-sharing rule starts after the minimum deductible if earlier credit would end health savings account eligibility. That delay does not apply to qualifying preventive care.
Stronger protections for your pharmacy choice
Beginning July 1, 2025, Iowa pharmacy benefits managers cannot limit your choice among participating pharmacies through financial penalties or promotions. They cannot vary your cost-sharing or add fees based on which pharmacy fills your prescription. They cannot require mail order for payment or impose costlier terms or stricter supply limits when another pharmacy offers equivalent services at the same cost and copayment. They also cannot unreasonably label drugs as specialty drugs to block access through an in-network pharmacy. You or a harmed pharmacy can challenge that label with Iowa’s insurance commissioner, who must consult the Board of Pharmacy.
Minimum payments for Iowa retail pharmacies
Beginning July 1, 2025, pharmacy benefits managers cannot pay Iowa pharmacies less than their affiliates for the same drug. Iowa retail pharmacies must receive at least the latest national average drug acquisition cost on the dispensing or administration date. If unavailable, the floor is wholesale acquisition cost; managers must also pay a $10.68 professional dispensing fee per prescription. Retail pharmacies exclude mail-order-only pharmacies and chains with at least 20 commonly controlled pharmacies located in at least 20 states. These rules exclude pharmacies in state-owned facilities and set pharmacy payments, not household prescription prices.
Drug rebates go to health plans
Beginning July 1, 2025, pharmacy benefits managers must pass 100% of rebates to insurers or employee plan sponsors, as federal law permits. Covered contracts made, amended, adjusted, or renewed on or after July 1, 2025 must require pass-through pricing for benefits beginning January 1, 2026. This means the payor’s drug payment equals what the manager pays the dispensing pharmacy or provider, including dispensing fees. Those contracts must also require service payments to be used or distributed as the contract or law directs. These rules do not guarantee lower household premiums or prescription costs.
Fairer pharmacy networks and clearer directories
Beginning July 1, 2025, pharmacy benefits managers must accept pharmacies that meet plan requirements and payment terms for similarly classified pharmacies. They cannot demand credentials beyond Iowa requirements; managers, insurers, plans, and payors cannot discriminate against law-abiding pharmacies and properly licensed pharmacists in participation, referrals, payments, or legal liability protection. Before restricting participation, payors must give all area pharmacies written notice and a chance to join at least 60 days ahead. Area pharmacies must be eligible under identical payment terms. Payors must tell members all participating pharmacies’ names and locations, and pharmacies may tell customers they participate.
Patients can enforce pharmacy rights
Beginning July 1, 2025, patients and pharmacies harmed by violations of the pharmacy-rights rules can ask a court to stop them. Iowa’s insurance commissioner cannot certify a pharmacy benefits manager or license an insurance producer that fails to follow those rules. The court remedy stops violations; this provision does not specify a damages payment.
Sponsors & Cosponsors
Sponsor
COMMITTEE ON HEALTH AND HUMAN SERVICES
Affiliation unavailable
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
legislature vote • 5/12/2025
Motion to suspend rules for immediate consideration of amendment H-1324
Yes: 21 • No: 69
House vote • 5/12/2025
Passed House
Yes: 75 • No: 15
Senate vote • 4/28/2025
Passed Senate
Yes: 36 • No: 14
Actions Timeline
Signed by Governor.
6/11/2025SenateFiscal note.
6/6/2025legislatureExplanation of vote.
5/20/2025HouseReported correctly enrolled, signed by President and Speaker, and sent to Governor.
5/19/2025SenateMessage from House.
5/12/2025SenateImmediate message.
5/12/2025HousePassed House, yeas 75, nays 15.
5/12/2025HouseMotion to suspend rules failed.
5/12/2025HouseMotion to suspend rules for immediate consideration of amendment H-1324, yeas 21, nays 69.
5/12/2025HousePoint of order raised on amendment H-1324, ruled not germane.
5/12/2025HouseAmendment H-1324 filed.
5/12/2025HouseAmendment H-1302 filed, withdrawn.
5/12/2025HouseSubstituted for HF 852.
5/12/2025HouseFiscal note.
5/7/2025legislatureFiscal note.
5/6/2025legislatureRead first time, passed on file.
4/30/2025HouseMessage from Senate.
4/29/2025HouseImmediate message.
4/28/2025SenatePassed Senate, yeas 36, nays 14.
4/28/2025SenateAmendment S-3104 out of order.
4/28/2025SenateAmendment S-3138 adopted.
4/28/2025SenateAmendment S-3139 filed, lost.
4/28/2025SenateAmendment S-3138 filed.
4/28/2025SenateDeferred.
4/28/2025SenateAmendment S-3104 filed.
4/16/2025Senate
Bill Text
As Introduced
Enrolled
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