All Roll Calls
Yes: 276 • No: 46
KansasSB 202025–2026 Regular SessionSenateWALLET
Enacting the Kansas consumer prescription protection and accountability act and providing for regulation and registration of pharmacy benefits managers.
Sponsored By: Sponsor information unavailable
Signed by Governor
insurancefinancial institutions and insurance
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Bill Overview
Analyzed Economic Effects
8 provisions identified: 4 benefits, 1 costs, 3 mixed.
Lower copays and no PBM fees
Your plan cannot make you pay a copay higher than what the pharmacy submitted for that drug. A pharmacy benefits manager cannot add point‑of‑sale or retroactive fees to you or your pharmacy. PBMs can still process deductibles and copays that the health plan approves.
Fairer pharmacy audits and timelines
Pharmacy audits follow stricter fairness rules. Auditors must give 14 days’ written notice and avoid the first five days of the month for pharmacies filling over 600 scripts a week, unless the pharmacy agrees. Audits can only look back 24 months and cover no more than 250 prescriptions; clinical-judgment audits involve a pharmacist. Auditors must accept common delivery and prescription records, give a list of reviewed records before leaving, send a preliminary report in 60 days, give pharmacies at least 30 days to respond, and issue a final report in 90 days. No extrapolation is allowed (unless federal law requires it), and dispensing fees are not included in overpayments unless a misfill; recoveries are limited to actual harm and only for set reasons like fraud or true over/underpayment. Clerical errors alone are not recouped unless they caused overpayment, and no interest accrues during the audit and appeal. Audit information stays confidential; prior audit reports are only accessible if prepared by the same auditor, and auditors cannot be paid only by how much they recoup.
Fair pharmacy pay tied to NADAC
PBMs must pay pharmacies at least the NADAC price plus a dispensing fee that is the greater of $10.50 or the K.A.R. 30‑5‑94 fee; if no NADAC exists, use WAC plus that fee. For NADAC drugs, PBMs must use the most recent monthly NADAC and charge health plans the same price they pay pharmacies. PBMs must file their reimbursement methods with the commissioner when licensed and when they change. PBMs must give pharmacies copies of contracts, amendments, payment schedules, and rates within 10 calendar days after they are signed or changed.
Approved claims stay; tougher fraud steps
Once a prescription claim is approved, it cannot be reversed unless the pharmacy got approval by fraud or misrepresentation. This rule does not apply to Medicare claims. If an audit shows signs of fraud, waste, abuse, or criminal wrongdoing, the normal audit protections do not apply. During an appeal, a PBM may withhold future payments above an identified discrepancy only when the discrepancy is over $25,000.
New PBM rebate and price transparency
PBMs must report each year the total rebates they received and how much they sent to each health plan, plus amounts paid and received for pharmacist services by pharmacy and product. Each year they must also report the total spread between what they paid pharmacies and what they charged plans. Every quarter, PBMs must publicly post drugs paid more than 10% below or above NADAC with key details, and keep the report online for at least 24 months. Health plans must report each year the total rebates, credits, and discounts they received from PBMs or drugmakers. Reports are filed electronically, cannot include protected health information, and are generally confidential except for the public NADAC variance report. The law defines rebates broadly and requires rebates not used to lower a person’s cost share to be passed to the health plan.
PBMs must be licensed and accountable
Any business acting as a pharmacy benefits manager in Kansas must hold a license. Applicants must file contacts, responsible individuals, service‑of‑process agent, template contracts with an affidavit, and a network adequacy report. The nonrefundable application fee and the annual renewal fee are each capped at $2,500; licenses expire March 31. PBMs must report material changes within 90 days or face penalties up to $2,000 per occurrence; late renewals can bring penalties up to $2,500 and suspension until paid. The commissioner can examine PBMs, charge exam costs, require reports, and suspend or revoke licenses for violations, including late reporting; fines can be up to $1,000 per act (cap $10,000), or up to $5,000 per act (cap $50,000 in six months) if the PBM knew or should have known. Acting without a license can be fined $5,000 to $100,000. The commissioner may also order reimbursement to covered persons, pharmacies, or dispensers for monetary losses tied to violations. PBM filings in applications, exams, or investigations are confidential until July 1, 2027, and a PBM licensure fund supports administration.
PBM enforcement rules in place July 2023
The Insurance Commissioner sets the rules needed to run and enforce this law. The deadline for those rules is July 1, 2023. The rules cover application and report content and related matters.
Registration and fees for pharmacy auditors
Any company that audits pharmacies in Kansas must register with the Insurance Commissioner before it operates. Registration needs an application and a nonrefundable fee up to $500, including business and contact details and a federal EIN if you have one. Registration ends each March 31. Renewal costs up to $250, with a late penalty up to $250 and possible suspension until all amounts are paid. The commissioner publishes the fee amounts by December 1 each year.
Sponsors & Cosponsors
Sponsors
There is no primary sponsor on record.
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
Senate vote • 4/23/2026
Yea: 32 Nay: 8
Yes: 32 • No: 8
Senate vote • 4/23/2026
Yea: 104 Nay: 17
Yes: 104 • No: 17
Senate vote • 4/23/2026
Yea: 100 Nay: 21
Yes: 100 • No: 21
Senate vote • 4/23/2026
Yea: 40 Nay: 0
Yes: 40 • No: 0
Actions Timeline
Enrolled and presented to Governor on Friday, April 3, 2026
4/9/2026SenateApproved by Governor on Thursday, April 9, 2026
4/9/2026SenateConference Committee Report was adopted; Yea: 32 Nay: 8
3/24/2026SenateConference committee report now available
3/23/2026HouseMotion to suspend rule 1502 adopted;
3/23/2026HouseSubstitute motion to not adopt and appoint a conference committee failed
3/23/2026HouseConference Committee Report was adopted; Yea: 104 Nay: 17
3/23/2026HouseMotion to accede adopted; Representative Sutton, Representative Bergkamp and Representative Neighbor appointed as conferees
3/11/2025HouseNonconcurred with amendments; Conference Committee requested; appointed Senator Dietrich , Senator Fagg and Senator Francisco as conferees
3/10/2025SenateCommittee of the Whole - Committee Report be adopted
3/7/2025HouseCommittee of the Whole - Be passed as amended
3/7/2025HouseEmergency Final Action - Passed as amended; Yea: 100 Nay: 21
3/7/2025HouseCommittee Report recommending bill be passed as amended by Committee on Insurance
2/27/2025HouseHearing: Wednesday, February 26, 2025, 3:30 PM Room 218-N
2/26/2025HouseFinal Action - Passed; Yea: 40 Nay: 0
2/19/2025SenateReceived and Introduced
2/19/2025HouseReferred to Committee on Insurance
2/19/2025HouseCommittee of the Whole - Be passed
2/18/2025SenateCommittee Report recommending bill be passed by Committee on Financial Institutions and Insurance
2/3/2025SenateHearing: Thursday, January 23, 2025, 9:30 AM Room 546-S
1/23/2025SenateReferred to Committee on Financial Institutions and Insurance
1/17/2025SenateIntroduced
1/16/2025Senate
Bill Text
As Amended by House Committee
As introduced
Enrolled
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