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Bill

HB 866

INSURANCE CLAIMS: Prohibits pharmacy benefit managers and managed care plans from reducing pharmacy reimbursements (OR +$11,093,778 SG EX See Note)

2026 Regular Session Introduced by Jason DeWitt

HB 866 blocks pharmacy benefit managers and managed care plans from cutting pharmacy reimbursement rates, costing Louisiana $11.1M annually in general fund spending.

Reported by substitute (12-0).
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Bill Summary · HB 866

Legislative bill overview

HB 866 prohibits pharmacy benefit managers (PBMs) and managed care plans from reducing pharmacy reimbursements below specified levels. The bill creates restrictions on how these intermediaries can adjust payment rates to pharmacies. It carries an estimated fiscal impact of $11.09 million in state general fund expenditures.

Why is this important

Pharmacy reimbursement rates directly affect whether independent and community pharmacies remain financially viable, particularly in rural areas. PBMs and managed care organizations currently have significant leverage to reduce what they pay pharmacies, and this bill attempts to establish a floor on those payments. The substantial fiscal note suggests the state may bear increased costs through Medicaid or other insurance programs affected by the reimbursement restrictions.

Potential points of contention

  • Cost burden: The $11M+ fiscal impact raises questions about whether taxpayers or insurance premiums will absorb higher pharmacy costs, and whether this represents good fiscal policy
  • Market intervention scope: Defining what constitutes an improper "reduction" and determining appropriate reimbursement floors involves complex healthcare economics that may be difficult to enforce consistently
  • Unintended consequences: PBMs and insurers may respond by reducing networks, limiting generic drug options, or shifting costs elsewhere in the healthcare system rather than accepting lower margins

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

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