TN HB2332

Pharmacy benefits managers (PBMs) must reimburse pharmacies at the highest of four rates: actual cost to the pharmacy, 105% of the national average drug acquisition cost (NADAC), wholesale acquisition cost (WAC) if NADAC unavailable, or the amount the PBM reimburses itself or affiliates for the same drug

PBMs that fail to meet minimum reimbursement requirements must pay the pharmacy twice the amount owed as a penalty, and pharmacies may file complaints with the Department of Commerce and Insurance

PBMs must pay professional dispensing fees at a rate no less than TennCare rates, and these fees cannot be passed to patients through copayments, deductibles, or other out-of-pocket costs

Appeal determinations must result in payment of additional monies owed within 7 business days, with appeal findings applied to all remaining refills on the prescription

Effective July 1, 2026, applying to policies, plans, and contracts entered into, renewed, amended, or modified on or after that date