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Bill

HB 1125

Pharmacy services; prohibit insurers and PBMs from requiring persons to obtain exclusively through pharmacies that they own.

2025 Regular Session Introduced by Gene Newman

Bill prohibits insurers and PBMs from requiring exclusive use of their owned pharmacies, preserving patient choice but potentially limiting their cost-control strategies.

Died In Committee
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Bill Summary · HB 1125

Legislative bill overview

HB 1125 would prohibit health insurers and Pharmacy Benefit Managers (PBMs) from requiring patients to use only pharmacies they own or operate. The bill aims to prevent insurers and PBMs from steering patients toward their own pharmacies through exclusionary requirements or financial penalties, preserving patient choice in where they fill prescriptions.

Why is this important

PBMs and insurers increasingly own pharmacy chains, creating conflicts of interest where they profit from steering patients to their own locations. This consolidation can limit patient access to independent pharmacies and neighborhood pharmacies, while potentially raising costs through reduced competition and higher copayments for non-preferred locations.

Potential points of contention

  • Business model impact: PBMs argue that owning pharmacies allows them to reduce costs through integration and that patients benefit from negotiated pricing at their own locations
  • Insurance cost concerns: Insurers may contend that restrictions limit their ability to manage pharmacy networks efficiently and could increase premiums for consumers overall
  • Defining "exclusive" requirements: The bill's scope is unclear—it's uncertain whether it applies to financial incentives (higher copays at non-owned pharmacies) versus hard exclusions, and whether mail-order pharmacy requirements are covered

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

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