TN SB2040

Prohibits pharmacy benefits managers (PBMs) from owning, controlling, or holding any beneficial interest in pharmacies in Tennessee, effective January 1, 2027, including through management contracts, revenue-sharing agreements, or other indirect arrangements

Requires all pharmacy license applicants and holders to file annual verified disclosures identifying owners with 5% or more interest, affiliated entities providing services, and any agreements giving PBMs authority to influence operations

Creates a limited-use pharmacy license exception for rare, orphan, or FDA-designated limited-distribution drugs otherwise unavailable in the state, with annual board review and automatic repeal on September 1, 2028

Establishes enforcement penalties of up to $10,000 per day for violations, authorizes the Board of Pharmacy to seek injunctive relief and issue subpoenas, and requires annual public reporting on enforcement actions beginning January 15, 2028

Mandates PBM-affiliated pharmacies notify patients and prescribers by November 1, 2026 of potential closure, with operations permitted through December 31, 2026 if actively pursuing sale to an unaffiliated entity (with possible 6-month extension)