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 704 Original 2024 Regular Session Chassion
Abstract: Provides a quality incentive program for pharmacy benefit managers.
Present law provides for the licensing of pharmacy benefit managers (PBMs) by the commissioner
of insurance (commissioner). Proposed law retains present law and requires each PBM licensed by
the commissioner to develop a program in consultation with a plan sponsor to provide incentive
payments to eligible independent network pharmacies for meeting benchmarks or complying with
strategies aimed at improving the health of La. residents covered by the pharmacy benefit manager.
Proposed law provides that the quality incentive program should focus on the health concerns most
affecting La. residents, may be designed in consultation with La. colleges of pharmacy, and may
reflect the unique needs of the state as designated by each of the nine La. Dept. of Health regions.
Proposed law requires, on or before Oct. first of each year, a PBM to report to the commissioner the
details of its program and provides for the minimum content of the report. Further requires the
program to be implemented on the following Jan. 1, 2025.
Proposed law requires, on or before April first of the following year, a PBM to report to the
commissioner the results of its quality incentive criteria from the previous calendar year. Proposed
law further provides for the minimum content of the report.
Proposed law provides that the PBM quality incentive program is strictly voluntary and prohibits an
independent network pharmacy from being penalized for declining to participate.
Proposed law provides for additional parameters of the PBM quality incentive program, including
the use of education and training programs.
Present law exempts Medicaid managed care organizations from certain provisions of the La.
Insurance Code. Proposed law retains present law and provides that Medicaid managed care
organization PBMs are exempt from proposed law.
Proposed law requires exempt PBMs to submit a notice of exemption to the commissioner and
provides that the PBM is no longer exempt if it renders services to La. residents who are not enrolled
in the Medicaid program.
Proposed law does not expand the scope of practice of a participating pharmacist. Proposed law defines "independent network pharmacy" as a pharmacy operating within the state
which is a member of a pharmacy benefit manager's network, considered to be in good standing by
the pharmacy benefit manager, and under common ownership with not more than two other
pharmacies.
Effective upon signature of governor or lapse of time for gubernatorial action.
(Adds R.S. 22:1657.2)