Insurance; require that final reimbursements to pharmacies for prescription drugs are based on certain formulas

Added definitions for 'affiliate pharmacy,' 'rural area' (counties with under 35,000 people), and 'rural pharmacy' to clarify who qualifies for special treatment under the law.

Added a new provision allowing pharmacy benefit managers to reimburse rural pharmacies at rates higher than the standard formula, with exceptions for affiliate, mail-order, and specialty pharmacies.

Changed the effective date from July 1, 2026, to July 1, 2027, and the applicability date from October 1, 2026, to October 1, 2027, giving more time for implementation.

Added 'definitions' and 'construction' to the bill's purpose statement to reflect the new definitional provisions and interpretive guidance.

The reimbursement formula was changed to tie the professional dispensing fee to the current Georgia Medicaid rate rather than a fixed $10.64 amount, and the fee adjustment mechanism was removed.

The definition of reimbursement was updated to explicitly account for all fees, charges, adjustments, or reductions before calculating the final amount owed to pharmacies.

The effective date was delayed from July 1, 2025 to July 1, 2026, and the applicability date was delayed from October 1, 2025 to October 1, 2026.

Exemptions were clarified to explicitly include state health plans and Medicaid managed care programs administered through care management organizations.