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HD 1358

An Act relative to pharmacy benefit managers

194th Legislature (2025-2026) Introduced by John Lawn

HD 1358 - An Act relative to pharmacy benefit managers OverviewBill Number: HD 1358 Title: An Act relative to pharmacy benefit managers Status: Proposed bill Introduced: Novembe

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Bill Summary · HD 1358

HD 1358 - An Act relative to pharmacy benefit managers

Overview

Bill Number: HD 1358
Title: An Act relative to pharmacy benefit managers
Status: Proposed bill
Introduced: November 29, 2025

Purpose and Intent

This proposed legislation aims to increase transparency and regulation of pharmacy benefit managers (PBMs) - the intermediaries between health insurers, pharmacies, and drug manufacturers. The bill's primary goals are to:

  1. Enhance oversight and accountability of PBM practices
  2. Protect consumers from excessive costs and unfair PBM policies
  3. Promote a more competitive and equitable pharmaceutical marketplace

Key Provisions

  • Requires PBMs to register and be licensed by the state's insurance commissioner
  • Mandates PBMs to disclose detailed information about their business practices, including:
    • Fees, charges, and reimbursement rates to pharmacies
    • Rebates and other payments received from drug manufacturers
    • Ownership interests or affiliations with pharmacies or insurers
  • Prohibits PBMs from engaging in "spread pricing" - the practice of charging health plans more than they reimburse pharmacies
  • Bans "gag clauses" that prevent pharmacists from informing patients about lower-cost medication options
  • Requires PBMs to apply all pharmacy benefit-related revenue, including manufacturer rebates, to reduce consumers' out-of-pocket costs

Affected Parties and Impacts

  • Consumers/patients: Increased transparency and lower out-of-pocket drug costs
  • Pharmacies: Fairer reimbursement rates and ability to inform patients about cost-saving options
  • Health insurers: Greater oversight and restrictions on PBM practices that inflate costs
  • Pharmacy benefit managers: Heightened regulation and disclosure requirements for their business operations

Procedural and Timeline Considerations

HD 1358 was introduced in the state legislature on November 29, 2025 and has been referred to the Joint Committee on Health Care Financing for review and consideration. If passed by the committee, the bill would then proceed to a full vote in the state House of Representatives. Given the bill's focus on consumer protection and bipartisan support, it is expected to advance through the legislative process in the coming months.

Compiled from official sources — confirm details with the bill’s official record.

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