NE LB198

Prohibits pharmacy benefit managers (PBMs) from using spread pricing in contracts with health benefit plans, with new contracts banned from this practice starting January 1, 2026, and a complete ban on all contracts by January 1, 2029

Prevents health carriers and PBMs from requiring patients to use mail-order or PBM-affiliated pharmacies exclusively, transferring prescriptions without patient consent, or using financial incentives that exclusively benefit PBM-affiliated pharmacies

Allows network pharmacies and pharmacists to decline dispensing a drug if reimbursement is less than acquisition cost, with protection from retaliation by PBMs for exercising this right

Establishes requirements for specialty pharmacies dispensing clinician-administered drugs, including 24/7 pharmacist access, federal shipping compliance, and delivery signature requirements with at least five business days advance notice

Permits retail pharmacies to offer prescription delivery services by mail, common carrier, or employee as an ancillary service, prohibiting PBMs from removing pharmacies from networks solely for providing such delivery services