MO SB968

Prohibits pharmacy benefit managers (PBMs) from limiting patients' choice of pharmacy or imposing monetary penalties like higher copays to steer patients toward specific pharmacies, including mail-order pharmacies

Requires PBMs to reimburse Missouri pharmacies at no less than the National Average Drug Acquisition Cost (NADAC) for prescription drugs on the date dispensed

Mandates PBMs pay pharmacies a dispensing fee of at least 90% of the MO HealthNet professional dispensing fee in addition to drug reimbursement

Requires PBMs to reimburse independent pharmacies at the same rate as their own affiliated pharmacies for dispensing the same prescription drug

Establishes a 14-day appeal process for pharmacies to dispute reimbursement rates, with protections against PBM retaliation for exercising appeal rights