VA HB631

Requires Virginia's Department of Medical Assistance Services to contract with a single state pharmacy benefits manager (PBM) by July 1, 2026, to administer all Medicaid pharmacy benefits, including for managed care organization enrollees

Mandates drug reimbursement based on national average drug acquisition cost (or wholesale acquisition cost minus a discount if unavailable) plus a professional dispensing fee, with prohibitions on spread pricing and steering patients to affiliated pharmacies

Requires the state PBM to allow any licensed pharmacy to participate in the network under equal terms and conditions, meet geographic network adequacy standards, and maintain accurate directory information

Directs the Department to annually calculate savings from using the state PBM and increase dispensing fees by that savings amount, with annual publication of savings achieved and updated fee schedules on its website

Establishes annual reporting requirements to the General Assembly by September 30 each year on PBM compliance, reimbursement trends, network adequacy, and dispensing fee sufficiency