RÉSUMÉ DIGEST
ACT 483 (SB 130) 2018 Regular Session Mills
New law requires Medicaid pharmacy benefit manager contracts to be limited to a set per
transaction rate for every pharmacy claim paid. Prohibits pharmacy benefit managers from
retaining federal drug rebates, credits, or "spread pricing" amounts in excess of what they
paid the pharmacist.
Allows the Louisiana Department of Health (LDH) to amend current contracts to comply
with these provisions. 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.
Requires LDH, after August 1, 2018, to include the provisions of prior law in any requests
for proposal for Medicaid managed care organizations or pharmacy benefit managers.
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 provided
the pharmacy or pharmacist meets all the requirements of participating in the state Medicaid
program.
Effective August 1, 2018.
(Adds R.S. 39:1648)