LA HB264

Prohibits pharmacy benefit managers (PBMs) from retaining manufacturer rebates, requiring all rebates to be passed through to plan sponsors as lower premiums, reduced cost-sharing, or broader drug coverage

Requires PBMs to reimburse local pharmacies (fewer than 10 retail outlets) at no less than the National Average Drug Acquisition Cost (NADAC) effective January 1, 2026, and prohibits effective rate pricing and spread pricing for local pharmacies

Mandates annual transparency reports from PBMs to the Department of Insurance detailing total rebates received, administrative fees, reimbursements to pharmacies, and complete corporate vertical integration structures

Creates the Pharmacy Benefit Manager Enforcement Fund in the state treasury and grants the attorney general independent authority to investigate violations, seek treble damages, and recover attorney fees

Prohibits patient steering to PBM-owned pharmacies and bars PBMs or health insurers from charging pharmacies any fees, with enforcement of key provisions beginning January 1, 2027