MS HB1123

Prohibits "spread pricing" by pharmacy benefit managers (PBMs) and pharmacy services administrative organizations (PSAOs), which is the practice of charging health plans more than what is paid to pharmacies for dispensing drugs

Requires drug manufacturers to submit quarterly reports on wholesale acquisition costs and justify price increases of 40% or more over 5 years or 10% or more in 12 months for drugs costing $70 or more per container

Mandates annual reporting by PBMs and PSAOs on rebates, fees, and payments collected from drug manufacturers, including how much was passed to health insurers, enrollees, and employers versus retained as revenue

Authorizes the Mississippi Board of Pharmacy to investigate violations, conduct audits, issue subpoenas, and impose penalties of $1,000 to $25,000 per violation; requires PBMs and PSAOs to disclose ownership affiliations with pharmacies

Prohibits PBMs and PSAOs from retaliating against pharmacists or pharmacies for exercising rights under this law, including terminating contracts, increasing audit frequency, or delaying payments; provisions apply to the Mississippi State and School Employees Health Insurance Plan and take effect July 1, 2025, with Sections 1-8 repealing June 30, 2028