MissouriModifies provisions relating to pharmacy benefits managers
What it does
SB 968 - Under this act, no pharmacy benefits manager shall prohibit or limit a covered person from selecting a pharmacy or pharmacist of their choice or impose a monetary advantage or penalty that would affect a covered person's choice if a pharmacy or pharmacist has agreed to participate in a covered person's health benefit plan. A pharmacy benefits manager shall not impose upon a pharmacy or pharmacist any course of study, accreditation, certification, or credentialing as a condition of participation that is inconsistent with, more stringent than, or in addition to what is required under state law. Additionally, a pharmacy benefits manager shall not pay or reimburse a pharmacy or pharmacist for an amount less than the most recently published National Average Drug Acquisition Cost (NADAC) for a prescription drug.
More detail
This act requires a pharmacy benefits manager to reimburse pharmacies for a drug at an amount that is the greater of the maximum allowable cost (MAC) pricing or the current NADAC pricing. Additionally, no pharmacy benefits manager shall retaliate against a contracted pharmacy for exercising its right to appeal a reimbursement dispute to the pharmacy benefits manager.
A pharmacy benefits manager shall reimburse any pharmacist or pharmacy located in this state for an amount equal to what the pharmacy benefits manager reimburses a pharmacy benefits manager affiliate for dispensing the same prescription drug.
Finally, in addition to the reimbursement amounts determined by the MAC and NADAC, a pharmacy benefits manager shall reimburse a pharmacy or pharmacist a dispensing fee no less than 90% of the MO HealthNet professional dispensing fee in effect on the date of service.
This act is similar to HB 1975 (2026). TAYLOR MIDDLETON
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Where it stands
- Introduced
- Passed Senate
- Passed House
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Mar 12Bill Combined w/SCS SBs 984 & 968Latest
- Jan 21Hearing Conducted S Families, Seniors and Health Committee
- Jan 8Second Read and Referred S Families, Seniors and Health CommitteeMinor
- Jan 7S First ReadMinor
- 2025
- Dec 1PrefiledIntroduced