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Bill

HB 1271

Health insurance; pharmacy benefits managers; requirements and prohibited conduct.

2026 Regular Session Introduced by Otto Wachsmann

HB 1271 regulates Virginia pharmacy benefits managers' pricing and conduct practices to address drug cost and access concerns, currently in legislative review.

Assigned HCL sub: Subcommittee #1
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Bill Summary · HB 1271

Legislative bill overview

HB 1271 establishes new regulatory requirements and prohibitions on pharmacy benefits managers (PBMs) operating in Virginia, likely addressing practices around drug pricing, formulary management, and pharmacy reimbursement. The bill was prefiled in January 2026 and is currently under review by the House Committee on Labor and Commerce with assignment to a subcommittee.

Why is this important

PBMs act as intermediaries between insurers, pharmacies, and drug manufacturers, controlling which drugs are covered and at what cost. Regulation of PBM practices directly affects medication affordability and access for Virginia residents, as well as the viability of independent and chain pharmacies. This reflects growing national concern about PBM consolidation and their role in rising drug costs.

Potential points of contention

  • Scope of prohibited conduct – Defining which specific PBM practices (e.g., "spread pricing," prior authorization delays, formulary restrictions) are prohibited versus permitted business practices
  • Implementation costs – Whether new compliance requirements impose administrative burdens that PBMs pass to insurers and consumers, potentially raising premiums
  • Economic impact on PBM market – Whether restrictions reduce competition or consolidation among PBMs, or conversely, whether they protect smaller pharmacies from unfair practices

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

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