VA SB669

Prohibits pharmacy benefits managers (PBMs) from charging pharmacies fees to process claims electronically and from reversing/resubmitting claims without prior written notification or more than one year after initial adjudication

Bans PBMs from retroactively denying or reducing claims unless the original claim was fraudulent, already paid, or services were not properly rendered

Requires PBMs to use pass-through pricing models and direct 100% of prescription drug manufacturer rebates to carriers, health plans, or directly to consumers to reduce out-of-pocket costs

Expands the law's scope to cover the Virginia state employee health plan while maintaining exemptions for self-insured ERISA plans, Medicaid, Medicare Part D, and CHIP

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