VA HB830

Prohibits pharmacy benefits managers (PBMs) from charging pharmacies fees to process claims electronically, reversing claims without written notice or more than one year after adjudication, and retroactively denying or reducing claims except for fraud or duplicate payment

Requires PBMs to use pass-through pricing models and direct 100% of prescription drug manufacturer rebates to carriers or directly to consumers at the point of sale to reduce cost-sharing amounts

Expands protections against PBM retaliation toward pharmacists, including prohibiting contract termination, increased audits without cause, or withholding payments as punishment for exercising legal rights

Extends coverage to the state employee health plan while exempting self-insured ERISA plans, Medicaid, Medicare Part D, and CHIP programs

Directs the State Corporation Commission to examine PBM practices that steer patients to PBM-affiliated pharmacies and report findings to the General Assembly by December 1, 2027, with main provisions taking effect July 1, 2027