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LouisianaSB 3872026 Regular SessionSenateWALLET

HEALTH/ACC INSURANCE: Provides relative to pharmacy benefit managers. (1/1/27) (EN INCREASE SG EX See Note)

Sponsored By: Adam Bass (Republican)

Signed by Governor

Insurance

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Bill Overview

Analyzed Economic Effects

9 provisions identified: 6 benefits, 1 costs, 2 mixed.

Drug managers must put patients first

Beginning January 1, 2027, pharmacy benefit managers must act solely for their health plans, insurers, and members. Managers and their corporate affiliates cannot use prohibited practices that raise drug costs or restrict access beyond plan-design requirements. They can favor a brand over an equivalent generic or biosimilar only when its cost after rebates is lower. That lower cost must reach members through lower out-of-pocket costs or premiums. The law also repeals R.S. 22:1868.1 and Section 5 of Act 474 of 2025 once Section 4 of the act originating as Senate Bill 401 of 2026 is enacted and effective. The supplied text does not describe the repealed rules or their effects.

Patients gain protection from costly drug steering

Beginning January 1, 2028, pharmacy benefit managers cannot require a more expensive brand when a cheaper same-class option is available. Alternatives can include another brand, a generic, a biosimilar, or another drug in that class. Managers also cannot require an affiliated manufacturer's drug when an available generic equivalent exists. For biological products, that protection requires an available biosimilar interchangeable with the prescribed product. These rules do not guarantee lower patient out-of-pocket costs.

Patients keep drug coverage through plan changes

Beginning January 1, 2028, managers generally cannot drop a drug an insured person takes during the policy year. They also cannot move it to a more restrictive or higher-cost tier, or raise copayments, coinsurance, or deductibles. This protection excludes renewal; removal remains allowed for FDA safety concerns, the required manufacturer discontinuation notice, or commercial over-the-counter availability. For drug-list changes at the start of a plan year, the same tier and cost sharing last 60 days after insurer notice. That 60-day rule excludes drugs sold over the counter, withdrawn by their manufacturer, or unavailable because of an involuntary recall.

Health plans receive drug rebates in full

Beginning January 1, 2027, pharmacy benefit managers and group purchasing organizations cannot keep negotiated rebates and fees. Manufacturer rebates go to health plan clients. Managers can receive only written-agreement flat service fees and flat bonuses tied to benchmarks for reducing total drug spending. Their fees and income cannot depend on listed drug prices, savings, rebates, premiums, deductibles, or patient cost sharing. Prohibited income must go to Louisiana client plans quarterly; a CEO or CFO must certify prior-year compliance by December 31. Contracts entered, amended, extended, or renewed starting January 1, 2027, must list all plan-paid revenue and acknowledge the spread-pricing ban. Spread pricing means charging plans more than pharmacies receive.

Pharmacies face shorter audits and simpler appeals

Beginning January 1, 2027, pharmacy audits generally occur no more than once yearly and review only the preceding 12 months of claims. Exceptions cover completing ongoing audits and the specified history of errors, inappropriate activity, or illegal activity. Pharmacies and pharmacists can combine substantially similar claims into one administrative appeal. For maximum allowable cost disputes, pharmacies have 15 business days after filling a prescription to appeal. Managers have 15 business days to respond.

Pharmacies gain protection for patient support services

Drug benefit managers and their affiliates or agents cannot block Louisiana pharmacies from offering services that improve drug access, transparency, or affordability. Pharmacies can offer these services themselves or through third parties, but are not required to offer them. Beginning January 1, 2028, managers cannot punish pharmacies for protected patient services or authorized claims-data sharing. Banned retaliation includes audits, investigations, termination threats, repayment demands, and other penalties; conflicting contract terms are unenforceable. This retaliation protection depends on Section 4 of the act originating as Senate Bill 401 of 2026 being enacted and effective.

Drug managers face fines and enforcement fees

Beginning January 1, 2027, specified duty violations can trigger fines equal to the greater of affected-party losses or manager-group gains. An additional $25,000 applies per violation, with no total cap. Violations of Section 1867.1 carry a separate $25,000 civil penalty per act or violation, also without a total cap. A fined violation left uncorrected for 30 days after notice requires license suspension or revocation. The commissioner can also charge reasonable enforcement fees, beyond license and annual-report fees, through Administrative Procedure Act procedures; no amount is set.

Drug managers face audits, gain privacy

Beginning January 1, 2027, the insurance commissioner and contracted plans can audit licensed drug benefit managers once per calendar year. Other legal or contract audit rights remain, and the commissioner can examine records across the manager's corporate structure. Managers must provide requested information within 30 days, with CEO or CFO certification that it is materially accurate and complete. Confidential audit data stay outside public records, including when handled by agents or downstream parties. The commissioner can share data with the Prescription Drug Affordability Board under its confidentiality protections. An added public-records exception for R.S. 22:1867.1 depends on Section 4 of the act originating as Senate Bill 401 of 2026 being enacted and effective.

State drug benefit auctions become optional

Beginning January 1, 2028, state drug benefit reverse auctions and specified contracting practices become recommendations rather than requirements. The first auction is recommended by July 1, 2028, with later auctions recommended at least every five years. Resulting contracts can start January 1, 2029. The Division of Administration must set bidding terms with platform-provider technical help, and changes require its specific consent. These provisions depend on Section 4 of the act originating as Senate Bill 401 of 2026 being enacted and effective.

Sponsors & Cosponsors

Sponsor

  • Adam Bass

    Republican • Senate

Cosponsors

  • Christopher Turner

    Republican • House

  • Kirk Talbot

    Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 253 • No: 31

House vote • 5/31/2026

Conference Committee Report read, roll called, yeas 76, nays 13. The Conference Committee Report was adopted.

Yes: 76 • No: 13

Senate vote • 5/29/2026

Conference Committee Report read; adopted by a vote of 36 yeas and 0 nays.

Yes: 36 • No: 0

House vote • 5/19/2026

Read third time by title, roll called on final passage, yeas 82, nays 14. Finally passed, ordered to the Senate.

Yes: 82 • No: 14

House vote • 5/12/2026

Reported favorably

Yes: 12 • No: 0

House vote • 4/29/2026

Reported with amendments

Yes: 10 • No: 4

Senate vote • 4/15/2026

Senate floor amendments read and adopted. Read by title and passed by a vote of 37 yeas and 0 nays; ordered reengrossed and sent to the House. Motion to reconsider tabled.

Yes: 37 • No: 0

Actions Timeline

  1. Signed by the Governor. Becomes Act No. 914.

    6/12/2026Senate

  2. Effective date: See Act.

    6/12/2026Senate

  3. Enrolled. Signed by the President of the Senate.

    6/1/2026Senate

  4. Signed by the Speaker of the House.

    6/1/2026House

  5. Sent to the Governor by the Secretary of the Senate on 6/2/2026.

    6/1/2026Senate

  6. Conference Committee Report read, roll called, yeas 76, nays 13. The Conference Committee Report was adopted.

    5/31/2026House

  7. Notice House adopted the Conference Committee Report.

    5/31/2026Senate

  8. Conference committee report received.

    5/29/2026Senate

  9. Rules suspended.

    5/29/2026Senate

  10. Conference Committee Report read; adopted by a vote of 36 yeas and 0 nays.

    5/29/2026Senate

  11. Conference Committee report received. Lies over under the rules.

    5/29/2026House

  12. Notice of Senate adoption of Conference Committee Report.

    5/29/2026House

  13. Scheduled for floor debate on 05/31/2026.

    5/29/2026House

  14. Senate conference committee members appointed: Talbot, Bass, and Harris.

    5/26/2026Senate

  15. Notice of Senate conferees appointed.

    5/26/2026House

  16. Notice of Senate rejecting House amendments.

    5/25/2026House

  17. House conferees appointed: Turner, Firment, and Miller.

    5/25/2026House

  18. Notice House Conference Committee members appointed.

    5/25/2026Senate

  19. Read third time by title, roll called on final passage, yeas 82, nays 14. Finally passed, ordered to the Senate.

    5/19/2026House

  20. Received from the House with amendments.

    5/19/2026Senate

  21. Read by title, passed to 3rd reading.

    5/18/2026House

  22. Scheduled for floor debate on 05/19/2026.

    5/18/2026House

  23. Reported without Legislative Bureau amendments.

    5/13/2026House

  24. Reported favorably (12-0). Referred to the Legislative Bureau.

    5/12/2026House

  25. Read by title, amended, recommitted to the Committee on House and Governmental Affairs.

    5/5/2026House

Bill Text

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