INSURANCE CLAIMS: Prohibits pharmacy benefit managers and managed care plans from reducing pharmacy reimbursements (OR +$11,093,778 SG EX See Note)

HB 866 prohibits pharmacy benefit managers (PBMs) and managed care plans in Louisiana from paying community pharmacies less than specific benchmarks for prescription drugs. It requires reimbursements to be at least the National Average Drug Acquisition Cost (NADAC) plus Louisiana's professional dispensing fee, or an approved alternative benchmark, and bans practices like "spread pricing" and "steering." The bill mandates "pass-through pricing," ensuring pharmacies receive payments directly without PBMs or plans keeping the difference. This directly affects Louisiana pharmacies and PBMs/managed care plans operating in the state, with violations subject to fines of $100,000+ per incident.