LA SB173

Pharmacy benefit managers (PBMs) are prohibited from reimbursing Louisiana pharmacies or pharmacists less than the acquisition cost for covered drugs, devices, or services, effective January 1, 2025

"Acquisition cost" is defined as the actual invoice price from a supplier/wholesaler for drugs and devices, or the Louisiana Medicaid professional dispensing fee for services

Protections apply only to pharmacies or pharmacists that do not own more than 5 shares or 5% interest in a pharmaceutical wholesale group purchasing organization or vendor

PBMs must report to the department all drugs by national drug code that have an established maximum allowable cost, and must allow appeals for at least 15 days following reimbursement

When a reimbursement appeal is granted, PBMs must allow the appealing pharmacy and all similarly situated pharmacies to reverse and resubmit claims with retroactive price adjustments in the next payment cycle