Louisiana governor signs sweeping pro-pharmacy legislation

by NCPA | Jun 07, 2019

Each week, we highlight a piece of state legislation introduced this session or a state regulatory initiative that could move the needle on changing the pharmacy payment model. To see what other states are doing, check out our legislation tracking map.

Louisiana Gov. John Bel Edwards on Thursday signed a package of pharmacy bills that were sponsored by Sen. Fred Mills and Rep. Bernard LeBas, both pharmacists.

A summary of the bills:

SB 41, introduced by Mills, requires PBM licensure; strengthens and expands current MAC laws, and prohibits spread pricing by PBMs without prior notice to the insurer. It also gives the board of pharmacy oversight authority.

  • SB 239, introduced by Mills, gives the Louisiana Department of Health greater oversight authority over the Medicaid prescription drug benefit program. The bill will permit the department to carve the drug benefit out of the Medicaid managed care program and will increase transparency by prohibiting spread pricing, preventing PBM conflicts of interest by limiting patient steering, and increasing patient access to pharmacy services by establishing "any willing pharmacist" standards for the Medicaid managed care program.

  • HB 242 ,introduced by LeBas, prohibits PBMs or health plans from assessing any fees that are not determined at the point of sale.

  • HB 433 ,introduced by LeBas, allows pharmacists to refuse to fill a prescription if the reimbursement is less than the acquisition cost. In addition, the legislation prohibits a PBM from penalizing or canceling a contract with the pharmacy should it refuse to fill the prescription.

  • HB 538, introduced by LeBas, limits audits and requires that audits must be done by or in consultation with a pharmacist licensed in Louisiana.