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Bill

HB 2773

Health insurance; cost-sharing, pharmacy benefits managers, compensation and duties, civil penalty.

2025 Regular Session Introduced by Paul Milde

Virginia bill establishes PBM regulations for cost-sharing and compensation practices with civil penalties, aiming to control pharmacy drug costs and insurance practices.

Left in Labor and Commerce
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WeVote Research Nonpartisan
Bill Summary · HB 2773

Legislative bill overview

HB 2773 would regulate pharmacy benefit managers (PBMs) in Virginia by establishing requirements for their compensation structures, cost-sharing practices, and operational duties related to health insurance. The bill includes civil penalty provisions for non-compliance with these regulatory requirements.

Why is this important

PBMs serve as intermediaries between insurers, pharmacies, and patients, controlling drug formularies and prices. Regulating their practices could affect medication costs and accessibility for Virginia residents, though it may also impact insurance premiums and pharmacy operations depending on implementation.

Potential points of contention

  • PBM industry opposition: PBMs may argue that regulatory restrictions limit their ability to negotiate drug prices and manage costs, potentially increasing insurance premiums
  • Definition and scope ambiguity: The bill's specific compensation and duty requirements may be unclear or overly broad, creating compliance challenges and litigation risk
  • Unintended market effects: Restricting PBM practices could reduce competition in pharmacy networks or lead to reduced services, particularly in rural areas
  • Federal regulatory overlap: Virginia's approach may conflict with or duplicate federal Medicare/Medicaid regulations, creating enforceability questions

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

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