GA HB810

Pharmacy benefits managers (PBMs) must reimburse eligible pharmacies at the national average drug acquisition cost plus the Georgia Medicaid professional dispensing fee, after accounting for all fees and reductions including DIR fees, administrative fees, and performance-based fees

Eligible pharmacies are defined as those not owned by entities with ownership interests in more than 10 pharmacies, effectively targeting independent pharmacies for protection

If national average drug acquisition cost is unavailable, reimbursement must equal the wholesale acquisition cost as of January 1, 2026, plus the Medicaid dispensing fee

PBMs may provide higher reimbursement to rural pharmacies (located in counties under 50,000 population per 2020 census), but this exception does not apply to affiliate, mail-order, or specialty pharmacies

The law does not apply to state health plans or Medicaid programs, and becomes effective July 1, 2027