RDCSB130 3837 3583
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)]
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 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.
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to
the engrossed bill:
1. Remove language allowing LDH to issue a requests for proposal for a single
pharmacy benefit manager.
2. Remove language allowing LDH to amend pharmacy services out of the current
Medicaid managed care organization contracts and issue a request for proposal
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to provide this service as long as it complies with the Louisiana Procurement
Code and the contracting requirements of proposed law.
3. Makes technical changes.
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