All Roll Calls
Yes: 234 • No: 0
NebraskaLB198109th Legislature 1st and 2nd SessionslegislatureWALLET
Change provisions of the Pharmacy Benefit Manager Licensure and Regulation Act
Sponsored By: Tony Sorrentino
Signed by Governor
Banking, Commerce and Insurance Committee
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Bill Overview
Analyzed Economic Effects
7 provisions identified: 2 benefits, 0 costs, 5 mixed.
PBM spread pricing ends by 2029
Contracts between PBMs and health plans issued on or after 2026-01-01 cannot use spread pricing, except extensions of older contracts. All PBM–plan contracts must end spread pricing by 2029-01-01. This increases pricing transparency and can reduce hidden markups that affect plan costs and premiums.
Mail-order stays optional with opt-out
Beginning 2026-01-01, plans, carriers, and PBMs cannot force you to use only mail‑order or a PBM affiliate, move your prescriptions without your request, or use incentives that help only an affiliate pharmacy. They may auto‑enroll you in mail‑order for a maintenance drug, but not during the first 90 days of a new one. You can opt out at any time. Mail‑order can be required only if another network pharmacy cannot provide the service.
Protect access to clinician-given drugs
Beginning 2026-01-01, PBMs and health carriers cannot force specialty pharmacies to ship clinician‑given drugs to patients to carry to a visit. They must authorize and pay a participating provider to obtain and give the drug when plan costs are substantially similar, and cannot punish a provider for refusing a PBM‑selected specialty pharmacy. Specialty pharmacies that ship these drugs must follow federal shipment and safety rules, give 24/7 pharmacist or nurse access, and provide track‑and‑trace data. Providers must give the delivery date, time, and place at least five business days ahead, and sign for delivery; if the drug is not delivered as arranged and cannot be given, the patient does not owe for it. PBMs and carriers must have an appeal/exception process when delivery fails or immediate treatment is needed. Some shipping and support duties do not apply when the provider and specialty pharmacy share ownership.
Pharmacies can refuse underpaid fills
Beginning 2026-01-01, a network pharmacy may refuse to fill a drug if payment is below its acquisition cost. If the pharmacy refuses, it must tell you where you can get the drug or refer you to the plan sponsor. PBMs and similar groups cannot punish or remove a pharmacy only for using this right.
Keep accredited specialty pharmacies in network
Beginning 2026-01-01, PBMs cannot exclude a Nebraska specialty pharmacy from a specialty network if it has national specialty accreditation and accepts network terms. PBMs cannot treat unaffiliated specialty pharmacies more harshly than their own affiliates. PBMs may request data no more than quarterly unless it is needed for legal reporting, payment integrity or rebates, accreditation, or is only available from the specialty pharmacy.
More local pharmacy delivery choices
Beginning 2026-01-01, contracts cannot stop local pharmacies from offering mail or local delivery when you ask. A prior confirmed delivery request can cover refills, so you do not need to ask each time. PBMs and plans cannot drop a pharmacy just for offering allowed delivery. Pharmacies cannot bill the plan or PBM for delivery unless the contract allows it. If a delivery fee is charged to you, the pharmacy must tell you the amount and that your plan may not reimburse it.
Updated definitions for PBM oversight
Beginning 2026-01-01, the law updates key terms in Nebraska’s PBM rules, including specialty pharmacy, PBM and affiliate, network pharmacy, and spread pricing. These definitions set who the rules cover and how the state oversees PBMs and pharmacy networks.
Sponsors & Cosponsors
Sponsor
Tony Sorrentino
legislature
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
legislature vote • 4/24/2026
Vote
Yes: 37 • No: 0 • Other: 12
legislature vote • 4/24/2026
Vote
Yes: 36 • No: 0 • Other: 13
legislature vote • 5/14/2025
Final Reading
Yes: 49 • No: 0
legislature vote • 5/1/2025
Vote
Yes: 39 • No: 0 • Other: 10
legislature vote • 5/1/2025
Vote
Yes: 37 • No: 0 • Other: 12
legislature vote • 5/1/2025
Vote
Yes: 36 • No: 0 • Other: 13
Actions Timeline
Provisions/portions of LB109 amended into LB198 by AM1201
6/6/2025legislatureApproved by Governor on May 20, 2025
5/21/2025legislatureDispensing of reading at large approved
5/14/2025legislaturePassed on Final Reading 49-0-0
5/14/2025legislaturePresident/Speaker signed
5/14/2025legislaturePresented to Governor on May 14, 2025
5/14/2025legislaturePlaced on Final Reading
5/12/2025legislatureEnrollment and Review ER76 adopted
5/8/2025legislatureAdvanced to Enrollment and Review for Engrossment
5/8/2025legislaturePlaced on Select File with ER76
5/7/2025legislatureEnrollment and Review ER76 filed
5/7/2025legislatureJacobson AM1229 to AM1201 filed
5/1/2025legislatureJacobson AM1229 adopted
5/1/2025legislatureBanking, Commerce and Insurance AM1201 adopted
5/1/2025legislatureAdvanced to Enrollment and Review Initial
5/1/2025legislaturePlaced on General File with AM1201
4/29/2025legislatureBanking, Commerce and Insurance AM1201 filed
4/29/2025legislatureBanking, Commerce and Insurance priority bill
3/12/2025legislatureSanders name added
3/6/2025legislatureHallstrom name added
2/11/2025legislatureNotice of hearing for March 03, 2025
1/29/2025legislatureReferred to Banking, Commerce and Insurance Committee
1/16/2025legislatureDate of introduction
1/14/2025legislature
Bill Text
Introduced
6/6/2025
Enrolled / Slip Law
Final / Enacted