DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of the
legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law
or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 864 Original 2016 Regular Session LeBas
Abstract: Prohibits health insurance issuers and pharmacy benefit managers from assessing certain
pharmacy claims fees.
Proposed law prohibits a health insurance issuer or a pharmacy benefit manager from directly or
indirectly charging or holding a pharmacist or pharmacy responsible for any fee:
(1)That is not apparent at the time of claim processing.
(2)That is not reported on the remittance advice of an adjudicated claim.
(3)After the initial claim is adjudicated.
(4) In order to participate in a specified provider network.
Proposed law further defines a "pharmacy benefit manager" as a person, other than a pharmacy or
pharmacist, who acts as an administrator in connection with pharmacy benefits.
(Adds R.S. 22:1860.2)