All Roll Calls
Yes: 363 • No: 0
Sponsored By: Katrina Callsen (Democratic)
Became Law
Pharmacy benefits managers; requirements; scope; report. Requires all health insurance carriers to use the pass-through pricing model and may limit a pharmacy benefits manager from deriving income from pharmacy benefits management services provided to a carrier except for income derived from a pharmacy benefits management fee. The bill prohibits a pharmacy benefits manager from (i) reversing and or resubmitting the claim of a pharmacist or pharmacy without meeting certain requirements, (ii) reducing any payment to a pharmacist or pharmacy to an effective rate of reimbursement, or (iii) retroactively denying or reducing a claim or aggregate of claims except under certain circumstances. The bill requires the State Corporation Commission (the Commission) to examine the practice of carriers or pharmacy benefits managers requiring or inducing covered individuals to utilize pharmacy services at an affiliated pharmacy. The Commission is required to report its findings and recommendations to the General Assembly by December 1, 2027. Certain provisions of the bill have a delayed effective date of July 1, 2027. This bill is identical to SB 669.
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6 provisions identified: 5 benefits, 0 costs, 1 mixed.
Starting July 1, 2027, PBMs and insurers must treat independent pharmacies fairly. They cannot pay you less than they pay their own affiliates for the same drug and service, counting rebates and fees. They cannot cut your pay with DIR‑style or “effective rate” reconciliations unless your contract clearly allows it. They cannot charge claim‑adjudication fees beyond a reasonable first submission, and they cannot charge for electronic claims. They cannot retaliate when you assert your rights. They cannot reverse and resubmit claims without written notice, just cause, and an attempt to reconcile, and not more than one year after acceptance. They cannot retroactively deny or cut claims except for fraud, duplicate payment, or services not properly given. If your non‑affiliate contract ends, they still must pay already‑approved claims, unless tied to a fraud investigation. They also cannot block your network spot over accreditation if your pharmacist meets the standard.
Starting July 1, 2027, insurers and PBMs cannot treat 340B covered entities or contract pharmacies worse just because of 340B status. They may still identify a 340B claim, and drugs costing over $250,000 per patient per year are not covered by this protection. Plans also cannot limit your pharmacy choice based on a pharmacy being a covered entity or contract pharmacy.
Starting July 1, 2027, insurers and PBMs cannot publish ads, offers, or claims that are untrue. This protects patients and pharmacies from misleading statements on coverage, price, or access.
Starting July 1, 2027, spread pricing is banned. Carriers must use pass‑through pricing, and if a plan sponsor asks, they must offer a contract that limits PBM pay to stated service fees. If a PBM negotiates manufacturer rebates, it must pass 100% to the health plan to lower premiums and cost‑sharing, or to the patient at checkout to lower copays, deductibles, or coinsurance. The State Corporation Commission can inspect these compensation arrangements, with confidentiality protections.
Starting July 1, 2027, insurers cannot count mail‑order or PBM‑affiliated pharmacies when proving a network has enough access. This makes network checks reflect local, in‑person pharmacy access.
Starting July 1, 2027, the state employee health plan must follow these PBM and carrier rules. Self‑insured ERISA plans, Medicaid, Medicare Part D, and CHIP are not covered by this law.
Katrina Callsen
Democratic • House
There are no cosponsors for this bill.
All Roll Calls
Yes: 363 • No: 0
House vote • 3/11/2026
Senate substitute agreed to by House
Yes: 98 • No: 0
Senate vote • 3/10/2026
Passed Senate with substitute Block Vote
Yes: 40 • No: 0
Senate vote • 3/10/2026
Commerce and Labor Substitute agreed to
Yes: 0 • No: 0
Senate vote • 3/9/2026
Passed by for the day Block Vote (Voice Vote)
Yes: 0 • No: 0
Senate vote • 3/9/2026
Constitutional reading dispensed Block Vote (on 2nd reading)
Yes: 40 • No: 0
Senate vote • 3/6/2026
Reported from Finance and Appropriations
Yes: 14 • No: 0
Senate vote • 3/2/2026
Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations
Yes: 14 • No: 0
House vote • 2/17/2026
Read third time and passed House Block Vote
Yes: 97 • No: 0
House vote • 2/13/2026
Reported from Appropriations with substitute
Yes: 22 • No: 0
House vote • 2/13/2026
Subcommittee recommends reporting with substitute
Yes: 7 • No: 0 • Other: 1
House vote • 2/5/2026
Reported from Labor and Commerce with substitute and referred to Appropriations
Yes: 22 • No: 0
House vote • 2/3/2026
Subcommittee recommends reporting with substitute and referring to Appropriations
Yes: 9 • No: 0 • Other: 1
Acts of Assembly Chapter text (CHAP0678)
Approved by Governor-Chapter 678 (Effective 7/1/2027)
Governor's Action Deadline 11:59 p.m., April 13, 2026
Enrolled Bill communicated to Governor on March 31, 2026
Signed by Speaker
Bill text as passed House and Senate (HB830ER)
Enrolled
Signed by President
Fiscal Impact Statement from State Corporation Commission (HB830)
Senate substitute agreed to by House (98-Y 0-N 0-A)
Passed Senate with substitute Block Vote (40-Y 0-N 0-A)
Commerce and Labor Substitute agreed to
Engrossed by Senate - committee substitute
Read third time
Passed by for the day Block Vote (Voice Vote)
Constitutional reading dispensed Block Vote (on 2nd reading) (40-Y 0-N 0-A)
Passed by for the day
Rules suspended
Reported from Finance and Appropriations (14-Y 0-N)
Committee substitute printed 26108906D-S1
Reported from Commerce and Labor with substitute and rereferred to Finance and Appropriations (14-Y 0-N)
Referred to Committee on Commerce and Labor
Constitutional reading dispensed (on 1st reading)
Read third time and passed House Block Vote (97-Y 0-N 0-A)
Engrossed by House - committee substitute
Chaptered
4/13/2026
Enrolled
3/30/2026
Substitute
3/3/2026
Substitute
2/13/2026
Substitute
2/5/2026
Substitute
2/4/2026
Substitute
2/3/2026
Introduced
1/13/2026
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