SB 1025 Summary

• Requires pharmacy benefits managers (PBMs) to pass through at least 85% of rebates received from pharmaceutical manufacturers to enrollees at the point of sale to reduce out-of-pocket costs.

• Prohibits PBMs from engaging in spread pricing, charging network participation fees, retroactively denying reimbursement, and engaging in discriminatory reimbursement practices between independent and PBM-owned pharmacies.

• Mandates PBMs provide quarterly reports to the Attorney General disclosing aggregate rebates received, rebates distributed to health insurers, rebates passed to enrollees, and itemized payments to providers.

• Establishes enhanced PBM licensing requirements including disclosure of management, beneficial ownership, surety bonds, and criminal history, with authority for the Attorney General to levy fines of $100-$10,000 per violation.

• Protects rebate information as trade secrets not subject to public records disclosure while requiring health insurers' pharmacy and therapeutics committees to operate transparently with clinical expertise and conflict-of-interest protections.

• Effective November 1, 2025.