Pharmacy benefit managers and pharmacy services administrative organizations; provide certain regulations for.
HB 1123 creates a broad regulatory framework for pharmacy benefit managers (PBMs) and pharmacy services administrative organizations (PSAOs) in Mississippi. The bill prohibits spread pricing in most health plan arrangements, requires contracts to spell out all PBM/PSAO revenue, and exempts self-funded health plans from that prohibition. It also requires drug manufacturers, PBMs/PSAOs, and health insurers to submit recurring reports to the Mississippi Board of Pharmacy on drug pricing, rebates, fees, utilization, and premium impacts.
The bill further directs the Board of Pharmacy to build and maintain a public-facing website to publish nonconfidential information received under the act, while protecting trade secrets and other proprietary data. It also requires PBMs and PSAOs to disclose ownership affiliations, pass through rebates to plan sponsors and employers, and prohibits retaliation against pharmacists, pharmacies, and pharmacy employees for exercising rights under the law or speaking to regulators or lawmakers. The Board is given authority to investigate, subpoena records, conduct audits, and impose monetary penalties for violations.
HB 1123 would expand the Mississippi Board of Pharmacy’s oversight authority over PBMs, PSAOs, drug manufacturers, and health insurers, and would add new reporting, disclosure, and enforcement obligations affecting prescription drug pricing and reimbursement practices. It would also bring forward and preserve existing Mississippi Code sections on reimbursement timing, maximum allowable cost lists, and pharmacy audit procedures, while layering new anti-retaliation and transparency requirements on top of those provisions. The act is set to take effect July 1, 2025, and Sections 1 through 8 are scheduled to repeal on June 30, 2028, making the new transparency and spread-pricing provisions temporary unless extended.
The bill appears to have received generally favorable support in both chambers, passing the House 89-8 and the Senate 46-4. Those vote totals suggest broad bipartisan agreement that PBM and PSAO practices warrant additional oversight and transparency. The absence of committee transcript material limits insight into detailed debate, but the strong margins indicate the bill was not highly divisive overall.
The main points of contention are likely to be the ban on spread pricing, the extensive reporting requirements, and the Board of Pharmacy’s expanded enforcement powers. PBMs and PSAOs may view the bill as burdensome because it requires disclosure of revenue streams, ownership ties, rebates, and operational data, and subjects them to audits and penalties. By contrast, pharmacists, independent pharmacies, and plan sponsors are the parties most likely to support the bill’s transparency, anti-retaliation, and reimbursement protections. The self-funded plan exemption and the temporary repeal of Sections 1 through 8 may also reflect compromise points intended to narrow the bill’s reach.