LA HB866

Pharmacy benefit managers (PBMs) and managed care plans cannot reimburse Louisiana pharmacies below NADAC (National Average Drug Acquisition Cost) plus the state's professional dispensing fee, or below what they pay their own affiliates and subsidiaries for the same drug.

Prohibits spread pricing, steering, and effective rate pricing practices; requires pass-through pricing for all covered claims, meaning the amount paid to pharmacies must be directly passed through to health plan sponsors.

PBMs may adopt reimbursement formulas using NADAC or a commissioner-approved alternative benchmark, with claim payment error rates limited to no more than 2% per drug.

Violations subject PBMs to sanctions including fines of $100,000 or more per violation within a calendar year.

Applies to contracts executed, amended, or renewed on or after July 1, 2026, for prescription benefits effective January 1, 2027.