The original instrument and the following digest, which constitutes no part of the
legislative instrument, were prepared by Christine Arbo Peck.
DIGEST
SB 130 Engrossed 2018 Regular Session Mills
Proposed law requires Medicaid pharmacy benefit manager contracts to be limited to a set per
transaction rate for every pharmacy claim paid. Proposed law prohibits pharmacy benefit managers
from retaining federal drug rebates, credits, or "spread pricing" amounts in excess of what they paid
the pharmacist.
Proposed law allows the Louisiana Department of Health (LDH) to amend current contracts to
comply with these provisions. Proposed law allows LDH to terminate the contract of any managed
care organization or pharmacy benefit manager who does not wish to adhere to these contract
provisions and issue a request for proposal to other pharmacy benefit managers.
Proposed law requires LDH, after August 1, 2018, to include the provisions of present law in any
requests for proposal for Medicaid managed care organizations or pharmacy benefit managers.
Proposed law allows LDH to issue a requests for proposal for a single pharmacy benefit manager.
Proposed law allows LDH to amend pharmacy services out of the current Medicaid managed care
organization contracts and issue a requests for proposal to provide this service as long as it complies
with the Louisiana Procurement Code and the contracting requirements of proposed law.
Proposed law establishes an "any willing provider" clause to prohibit Medicaid managed care
organizations or pharmacy benefit managers from denying Louisiana licensed pharmacies and
pharmacists from the opportunity to participate in the plan provider networks.
Effective August 1, 2018.
(Adds R.S. 39:1648)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to the
original bill
1. Adds credits owed to the state to the items that a pharmacy benefit manager may not
retain.
2. Makes provisions regarding immediate application of the contract requirements
permissive.
3. Makes requirement for a single state pharmacy benefit manager permissive. 4. Provides an "any willing provider" clause to prohibit Medicaid managed care
organizations or pharmacy benefit managers from denying Louisiana licensed
pharmacies and pharmacists the opportunity to participating in the plan provider
network.