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LR 124

Interim study to examine the role of a pharmacy benefit manager within the Nebraska health insurance industry and the impact on prescription drug prices

109th Legislature (2025-2026) Introduced by Mike Jacobson

Interim study on Nebraska PBMs to assess impact on prescription prices, transparency, and access, with findings guiding potential regulations for plans, pharmacies, and patients.

Referred to Banking, Commerce and Insurance Committee
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Bill Summary · LR 124

Summary of Legislative Resolution LR124 (Nebraska)

Overview

  • Bill Type: Legislative Resolution (interim study)
  • Bill Number: LR124
  • Title: Interim study to examine the role of a pharmacy benefit manager (PBM) within the Nebraska health insurance industry and the impact on prescription drug prices
  • Sponsor: Primary — Jacobson
  • Intro/Status: Introduced April 16, 2025; referred to Executive Board on introduction; subsequently referred to the Banking, Commerce and Insurance Committee (May 19, 2025)
  • Legislative Session: One Hundred Ninth Legislature, First Session

Purpose

LR124 proposes an interim study to:
- examine the role of PBMs in Nebraska’s health insurance landscape and their effect on prescription drug prices
- evaluate the transparency and accountability of PBM practices
- identify potential legislative or regulatory solutions to address concerns related to PBM conduct
- address the rising cost burden of prescription medications for Nebraskans

Key Provisions and Scope of the Study

The resolution outlines specific areas the interim study shall include, but not be limited to:
1. The contractual relationship among a PBM, a health insurance plan, and a pharmacy
2. Reimbursement models used by a PBM, including spread pricing and rebates
3. Formulary management practices of a PBM, including drug utilization review and prior authorization requirements
4. The impact of PBM practices on patient access to affordable prescription medications
5. The degree of transparency in PBM operations
6. The effects of PBM practices on independent pharmacies

Committee Assignment and Reporting

  • Designated Committee for Study: Banking, Commerce and Insurance Committee
  • Reporting Requirement: Upon conclusion of the study, the committee must prepare a report of findings and recommendations and submit it to the Legislative Council or Legislature

Procedural and Timeline Notes

  • Introduced: April 16, 2025
  • Initial Referral: Executive Board (April 16, 2025)
  • Subsequent Referral: Banking, Commerce and Insurance Committee (May 19, 2025)

Impact and Stakeholders

  • Directly Affected: PBMs, health insurance plans, pharmacies (including independent pharmacies), patients
  • Broader Implications: The study could inform future policy or regulatory actions aimed at increasing transparency, addressing price drivers in PBM practices (e.g., rebates, spread pricing, prior authorizations), and improving patient access to medications.

Nature of the Measure

  • LR124 is a resolution authorizing an interim study, not a bill imposing requirements or creating new law. It seeks to produce findings and recommendations to guide potential future legislative or regulatory action.

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

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