Bills: SB20, SB111, SB211, SB218, SB14

Keywords: prior authorization, pharmacy benefits manager, PBM, health insurer, prescription drugs, step therapy, formulary, auto-adjudication, electronic portal, appeals, medical necessity, serious mental illness, mental health, schizophrenia, bipolar disorder, major depression, substance use disorder, addiction treatment, cancer, autoimmune disorder

Bills: SB101, SB21, HM52, HB132, SB14, SB20

Keywords: SB 101, Health Care Delivery and Access Act, repeal of repeal, sunset repeal, delayed repeal, health care, healthcare, access to care, medical services, provider regulation, state health law, New Mexico, SB 21, Medicare supplement, Medigap, open enrollment, guaranteed issue, birthday month enrollment, health insurance, insurance regulation

Transcript Highlights:

• The first one, number one, on this one-page handout relates to the PBMs that are in IBAC, so that they
• We do regular PBMs, but in the case with the IBAC entities, the PBMs have a direct contract with the
• Right now, with this change, if a state employee, for an example, has a complaint, and the PBM is not
• And then a PBM is a pharmacy benefit manager, just because I know sometimes people are not familiar with
• authorization will not make patients safer and will only increase costs by removing an important tool PBMs

Bills: SB20, SB53, SB86, SB96, SB129

Keywords: prior authorization, pharmacy benefits manager, PBM, health insurer, prescription drugs, step therapy, formulary, auto-adjudication, electronic portal, appeals, medical necessity, serious mental illness, mental health, schizophrenia, bipolar disorder, major depression, substance use disorder, addiction treatment, cancer, autoimmune disorder

Bills: SB209, SB248, HB122, SB99, SB209, SB248, HB122, SB99

Keywords: sales tax exemption, Consumer Price Index, local government, clothing, school supplies, emergency preparedness, Alabama Administrative Procedure Act, APA, administrative law, judicial review, agency deference, Chevron deference, de novo review, contested case, state agency, regulatory power, individual liberty, statutory interpretation, rule interpretation, license revocation

Transcript Highlights:

• PBMs exist to drive down costs.
• PBMs exist to drive down costs.
• PBMs exist to drive down costs.
• So nobody seems to know how much PBMs are making. We know what PBMs are doing, right?
• While we are here, while there are several PBM-related bills, While we are here, there are several PBM-related

Keywords: 995, all

Summary: The committee held a lengthy hearing on a large docket of pharmacy and drug-pricing bills, with most testimony focused on PBM reform, 340B drug discount program protections, specialty medication access, and medication adherence. Chair James Murphy and Senator Paul Feeney opened the hearing and took testimony from legislators, patient advocates, pharmacists, health center leaders, industry representatives, and policy groups. Several speakers described delays, denials, high out-of-pocket costs, and pharmacy closures tied to PBM practices, while others emphasized the importance of community health centers and independent pharmacies in serving patients. On the 340B program, supporters including Senator Eldridge, Senator Payano, Community Care Cooperative, Fenway Health, the Massachusetts League of Community Health Centers, and several community health center leaders argued that bills such as H. 1107 and S. 819 would stop discriminatory PBM and manufacturer practices, preserve contract pharmacy access, and protect safety-net providers that say they reinvest savings into care, pharmacy expansion, interpreter services, behavioral health, and other services. Opponents including PhRMA, the Community Liver Alliance, and a public policy analyst argued the program lacks transparency and accountability, has grown beyond its original purpose, and may benefit large hospitals and for-profit entities more than low-income patients. They urged more reporting and oversight rather than expanding protections. On PBM reform, testimony supported bills including H. 1157, H. 1234, S. 724, S. 831, and related measures that would require rebate pass-through, ban spread pricing, limit steering to PBM-owned pharmacies, and improve reimbursement for community pharmacies. Independent pharmacists and patients said current PBM practices raise costs, create administrative burdens, and threaten access to local pharmacies. PCMA, representing PBMs, opposed the reforms, arguing PBMs lower costs, that plan sponsors choose to contract with them, and that the Health Policy Commission and CHIA should complete their ongoing study before new mandates are adopted. The committee also heard support for H. 1322 and S. 734 on specialty medications, and for H. 781 and H. 1305 on medication synchronization to improve adherence. No votes or formal actions were taken during the hearing.

Transcript Highlights:

• So I have a PBM 938, and it's a different way of looking at how we regulate PBMs between administration
• PBMs, we've seen that PBM pricing has fallen significantly.
• Control of our PBM services.
• PBM pricing is notoriously opaque and non-transparent.
• I'm sure a lot of other PBMs...

Bills: SB511, SB512, HB591, HB909, HB938, HB1154, HB1187

Keywords: automobile repairs, insurance transparency, repair shop liability, non-OEM parts, policyholder rights, automobile insurance, appraisal process, insurance policyholders, dispute resolution, claim valuation, family leave, insurance, paid leave, employment benefits, caregiver support, behavioral health, crisis services, mental health care, insurance coverage, healthcare access

Transcript Highlights:

• reform which is a PBM reform which is a PBM reform bill.
• And since the beginning of the PBM beginning of the PBM beginning of the PBM industry, they have continued
• You know, the PBM know, the PBM know, the PBM industry goes into the business industry goes into the
• The drug cost him $148 and the PBM $148 and the PBM $148 and the PBM ministry allowed him a ministry
• Uh Uh Uh but PBM once again the PBM ministry took but PBM once again the PBM ministry took but PBM once

Bills: SCR 13, SCR 24, SB 1, SB 12, SB 15, SB 17, SB 24, SB 57, SB 65, SB 213, SB 371, SB 372, SB 378, SB 379, SB 388, SB 400, SB 402, SB 427, SB 495, SB 499, SB 502, SB 509, SB 535, SB 583, SB 610, SB 621, SB 650, SB 706, SB 740, SB 840, SB 854, SB 856, SB 875, SB 893, SB 918, SB 925, SB 974, SB 995, SB 1006, SB 1018, SB 1025, SB 1061, SB 1073, SB 1106, SB 1121, SB 1194, SB 1252, SB 1253, SB 1268, SB 1300, SB 1343, SB 1362, SB 1447, SJR 36, SJR 12, SJR 57, SCR 25, SCR 22, SCR 12, SCR 24, SCR 8, SB 565, SB 372, SB 765, SB 62, SB 666, SB 707, SB 888, SB 687, SB 847, SB 1248, SB 740, SB 14, SB 1006, SB 504, SB 925, SB 1121, SB 995, SB 857, SB 305, SB 296, SB 284, SB 815, SB 1379, SB 1300, SB 1497, SB 1499, SB 1498, SB 1061, SB 65, SB 241, SB 304, SB 402, SB 499, SB 621, SB 974, SB 1023, SB 1024, SB 1025, SB 1106, SB 686, SB 112, SB 371, SB 204, SB 400, SB 609, SB 1447, SB 670, SB 502, SB 427, SB 850, SB 854, SB 413, SB 1555, SB 1362, SB 1346, SB 1033, SB 1220, SB 1073, SB 810, SB 987, SB 1539, SB 893, SB 447, SB 875, SB 406, SB 509, SB 985, SB 965, SB 1119, SB 1505, SB 24, SB 57, SB 1194, SB 1253, SB 1215, SB 1532, SB 1268, SB 1302, SB 856, SB 650, SB 583, SB 673, SB 840, SB 213, SB 681, SB 1172, SB 1252, SB 378, SB 610, SB 918, SB 1343, SB 608, SB 487, SB 955, SB 957, SB 988, SB 990, SB 1019, SB 1021, SB 1120, SB 251, SB 958, SB 535, SB 761, SB 1, SB 541, SB 315, SB 379, SB 1018, SB 1737, SB 266, SB 1415, SB 57, SB 499, SB 974, SB 1025, SB 1061, SB 1268, SR 302, SR 303, SR 304, SR 305, SB 30, SB 1333, SB 1666, SB 30, SB 1333, SB 1666

Keywords: water rights, treaty compliance, Rio Grande, agriculture, drought, international water, Texas water supply, Texas, Israel, trade, investment, partnership, economic ties, technological innovation, bilateral relations, appropriations, budget, state funding, education, healthcare

Transcript Highlights:

• The PBM must make the pharmacy whole.
• The PBM must make the pharmacy whole.
• The PBM must make the pharmacy whole.
• approaches a client to process... ...when a PBM approaches a client to be their PBM claim processor,
• We also have not seen any PBMs going underwater. I haven't seen any PBMs going underwater.

Bills: SB25, SB250, HB22, HB27, HB33, HB47, HB233, HB290, HB308, HB324, HB382, HB533, HB559, HB575, HB980, HB1157, HB1207, HB1236, HCR45

Keywords: registrar of voters, parish registrar, chief deputy registrar, confidential assistant, election administration, elections, salary schedule, compensation, merit evaluation, population-based pay, census-based pay, Department of State, Secretary of State, State Board of Election Supervisors, redistricting, senate districts, Senate District 33, Senate District 34, Senate District 35, precincts

Transcript Highlights:

• How do PBMs extract money from patients?
• Through conversations with insurers and PBMs, we have been meticulous in making sure that PBMs will be
• This bill requires a report from health insurance carriers and PBMs that will shed light on how PBMs
• I want to wrap up by acknowledging that not all PBMs are bad, and this bill does not get rid of PBMs.
• So as I understand it, PBMs...

Bills: AB93, AB204, AB414, AB504, AB598

Keywords: public employees, police officers, benefits, appropriation, law enforcement, medical debt, collection agency, healthcare, consumer protection, financial assistance, occupational safety, air quality, greenhouse gases, employee monitoring, safety program, hemp, hemp products, cannabidiol, CBD, cannabis

Transcript Highlights:

• Many of these pharmacies own their own PBM, and you can see at the... ...their own PBM, and you can see
• What we're finding is the PBM is forcing the... ...we're finding is the PBM is forcing the patient to
• the PBM is more expensive.
• We are in favor of PBM. We are in favor of PBM reform.
• My members do not own a PBM; they compete with drugstores that do own PBMs.

Keywords: 923, senate, all

Transcript Highlights:

• PBMs are not against them. Many PBMs, including our own PBMs are not against them.
• Many PBMs, including our own in-state PBM, have these types of programs.
• PBMs are not against them. Many PBMs, including our own in-state PBM, has these types of programs.
• And, I mean, it seems that we're just targeting PBMs.
• just targeting PBMs.

Bills: HB591, HB765, HB826, HB870, HB938, HB1151, HB1162, HB1176, HB1196, HB1236, HB1241

Keywords: family leave, insurance, paid leave, employment benefits, caregiver support, liability insurance, coverage defenses, direct action, judgment enforcement, legal procedures, insurance referrals, compensation, non-licensed agents, consumer protection, insurance products, HB 870, Act 907, Louisiana insurance, health insurance, prescription drugs

Transcript Highlights:

• It's important to remind this committee that PBM clients do not have to use PBMs.
• PBM clients, being unions, the state plans, and large employers, make the decision to use PBMs because
• One is that there are three major PBM providers.
• The PBM industry in 2022 alone was a $482.4 billion industry.
• As a PBM, do you have access to these transactions like that data?

Summary: The committee heard several health-related measures. SB 27 by Senator Umberg would revise and expand California’s CARE Court by limiting the expansion to people with bipolar I disorder with psychotic features, clarifying the definition of “clinically stabilized,” and narrowing the role of nurse practitioners and physician assistants. Supporters, including behavioral health officials and family members, said the bill would reduce dismissals and better serve people with severe illness; opponents warned the expansion would strain county staffing and housing resources and could undermine voluntary engagement. The bill passed on a do pass motion to the Committee on Public Safety. SB 503 by Senator Weber Pierson would require AI tools used in health care facilities to be identified, monitored, and mitigated for bias when used in clinical decision-making or resource allocation. The author and supporters from Kaiser Permanente and the California Medical Association said the bill would help prevent discriminatory outcomes and improve trust and safety. The committee discussed the need to clarify developer and deployer responsibilities, and the bill passed as amended to Privacy and Consumer Protection. SB 68 by Senator Menjivar would require restaurants to provide written allergen information for the top nine food allergens, with tiered flexibility for smaller establishments. The bill was supported by patients, families, nurses, and allergy organizations, who described severe reactions and the difficulty of relying on verbal disclosures alone. The California Restaurant Association opposed unless amended, seeking broader use of the national model food code and additional liability language. The bill passed as amended to Appropriations. The committee also heard SB 403 by Senator Blakespear, which would remove the sunset from the End of Life Option Act; supporters described the law as a compassionate, well-functioning option for terminally ill patients, while faith-based groups opposed it. The bill passed to Judiciary. Later, SB 41 by Senator Wiener was introduced to rein in pharmacy benefit manager practices that steer patients to mail-order pharmacies and reimburse community pharmacies below cost; community pharmacists and several health organizations testified in support, describing pharmacy closures and patient access problems.

Transcript Highlights:

• Over the last 10 years, we have seen PBMs increase their worth.
• PBMs claim they save money. Let me repeat that.
• PBMs are Fortune 500 top 50 companies PBMs are publicly traded on Wall Street.
• We have more than 50 different PBMs in the state of Oklahoma.
• There are PBMs that are doing the right thing and working well.

Bills: SB1673, SB1500, SB1447, SB1646, SB2007, SB1275, SB2074

Keywords: prosthetics, health insurance, medical necessity, patient rights, insurance liability, pharmacy benefits manager, healthcare providers, claims processing, reimbursement, insurance regulation, employees insurance, contract awarding, certifications, state procurement, insurance plan, mental health, substance use disorders, utilization review, benefit coverage, pharmacy

Transcript Highlights:

• PBMs and all of that, but I think, is there a need?
• If local pharmacies fail, then the health care... ...established by PBMs.
• of insurance and PBMs.
• And those three PBMs: Cigna owns a PBM named Express Scripts, UnitedHealth Care owns a PBM named Optum
• So, upper payment limit gets the PBMs out of the picture, right?

Keywords: 995, all

Summary: The Joint Committee on Health Care Financing held a public hearing on a broad set of health care bills focused on cost, market oversight, pharmaceutical access, transparency, hospital closures, and pharmacy access. Chairs John Lawn and Cindy Friedman opened by emphasizing recent health care reforms and the need for further action on the drug supply chain, PBMs, private equity, and affordability. The committee heard testimony on several measures, including a Betsy Lehman Center bill to make technical changes and create a permanent trust account for federal and private funding, and bills on hospital profits and fairness, hospital closures and health planning, pharmacy deserts, and health care market oversight and pharmaceutical access. No votes were taken during the hearing. On the hospital profits bill, physicians and labor advocates strongly supported capping hospital CEO compensation at 50 times the lowest-paid worker, requiring greater financial transparency, and directing penalties from high-margin public hospitals into a Medicaid reimbursement fund. Testifiers argued that executive pay is excessive while frontline staff and safety-net services are under strain. Committee members raised concerns about unintended consequences, including whether hospitals might shift workers to contract status or lose executive talent, and whether the bill would actually direct money to the safety net. Supporters responded that the measure is one piece of a larger effort and that the bill’s Medicaid reimbursement provisions would help underserved hospitals. Testimony on market oversight and pharmaceutical access centered on rising health care and drug costs, PBM practices, and the proposal to give the Health Policy Commission authority to set upper payment limits for certain drugs. Consumer advocates, disability advocates, an independent pharmacist, the Attorney General’s office, and others supported stronger oversight, citing premium increases, affordability problems, and the impact of high drug prices on patients and community pharmacies. Pharma and some industry witnesses opposed parts of the bill, warning that upper payment limits could disrupt access, create legal issues, and fail to address the broader supply chain. The committee also heard support for stronger hospital closure notice and public hearing requirements, and for a pharmacy deserts bill aimed at identifying and addressing closures like the one in Roxbury that affected thousands of patients.

Transcript Highlights:

• Right now, three companies oversee two-thirds of the PBM market in the nation, with over 80% of PBMs
• He owns the PBM.
• Are you going to tell those PBMs, you got to drop your price down to what this one PBM that I own was
• I'm not saying a vertical PBM, but they've got a PBM that they work with, they gave him the... best deal
• that lower rate for the patient is because that health plan, who owns the PBM, the PBM is skimming..

Bills: HB712, HB722, HB946, HB1687, HB1809, HB1899, HB2528, HB2583, HB2741, HB2750, HB3021, HB3150, HB3265, HB3658, HB3812, HB3960, HB4392, HB4432

Keywords: prostate cancer, health benefit plans, insurance coverage, cost sharing, preventive health care, auto insurance, total loss evaluation, disclosure, insurance materials, vehicle appraisal, HB 946, Texas Insurance Code, automobile insurance claims, oral release, written release, settlement agreement, claim release, property damage, bodily injury, psychological injury

Transcript Highlights:

• So will PBM then just raise the Okay?
• So the plans, the PBMs, and the prices.
• at all is the ability to uh of the PBMs at all is the ability to uh of the PBMs quite<01:10:32.000
• Uh, it's seamless to PBMs can do this.
• /c><01:16:35.360> manufacturers, PBMs, the PBMs blame the manufacturers, PBMs, the PBMs blame

Keywords: 1183, house

Transcript Highlights:

• We're talking about the PBM. The PBM. Yeah. OK. Yeah. All right, thank you. Mr.
• So you can tell those PBMs you gotta drop your price down to what this one PBM that I owned was selling
• And, and, um, they've got, I'm not saying a vertical PBM, but they've got a PBM that they work with.
• They all have integrated PBMs, right?
• Um, PBMs can be paid in one of three ways.

Transcript Highlights:

• <00:19:12.360> rebates the list price to afford PBM rebates the list price to afford PBM rebates
• to their medical management plan pbms to their medical management plan pbms will<00:20:19.080>
• In this example, the PBM negotiated price would be 52.
• I would like to note we have talked about PBMs several times before.
• It's section 12(d): it doesn't require insurers and PBMs to disclose detailed rebate information.

Keywords: Meeting Start: 00:00 Roll Call: 00:10 SB145 Discussion: 02:23 SB145 Vote: 05:13 SB183 Discussion: 06:13 SB183 Vote: 11:37 HB413 Discussion Only: 16:15, 958, all

Summary: The House Standing Committee on Banking and Insurance met with a quorum and first took up Senate Bill 145, sponsored by Sen. David Givens. The bill would update retail installment contract statutes for automobile sales, allowing retailers with installment contracts shorter than 28 days to begin collections after three days instead of waiting for multiple missed payments, and it also harmonizes a related dollar amount in statute from $10 to $15. The committee asked no questions, and the bill received a favorable expression on a roll-call vote. The committee then heard Senate Bill 183 from Sen. Matt Nunn, with testimony from Chris Nolan of the American Property Casualty Insurance Association. The bill would require proxy advisers acting for the State Retirement System to act solely in the financial interest of current and future retirees and to avoid political or social considerations in shareholder voting recommendations. Supporters argued it would keep politics out of public pensions and align proxy advice with fiduciary duties; members praised the bill and noted Kentucky could be among the first states to adopt such a model. The committee approved the bill with favorable expression after a roll-call vote. The committee also reviewed administrative regulation 808 KAR 9:10 from the Department of Financial Institutions, with no vote required. It then took up House Bill 413, a PBM rebate pass-through bill, with testimony from Sarah Wood of the Diabetes Patient Advocacy Coalition. She said the bill would require 85% of negotiated drug rebates to be passed through to patients at the point of sale, lowering out-of-pocket costs, especially for high-rebate drugs such as insulin, while still allowing 15% to remain with plans. She cited examples from other states and argued the bill would benefit about 650,000 Kentuckians. Hope McClaflin of Anthem opposed the bill, saying it would reduce employers’ ability to use rebates to lower premiums, could disproportionately favor high-cost brand-name drug users, and could create significant costs for state and fully insured plans. Members asked questions about other states’ pass-through rates and the effect on premiums, but no final action on House Bill 413 was taken in the portion of the meeting provided.

Transcript Highlights:

• Those are the sections of code that apply directly to PBMs.
• Section 16 transfers the existing fund... ...the PBM regulation.
• what would be turned over to the general fund for setting up and running the PBM regulation.
• Section 1, where we do allow for the licensure not to exceed $10,000 for a PBM license.
• However, you know, it's not uncommon for insurance commissioners to be regulating PBM.

Keywords: 908, all

Summary: The Senate Committee on Industry and Business reconvened to work on House Bill 1584, which would create a new pharmacy benefit manager (PBM) regulatory structure within the Insurance Department. Insurance Commissioner John Godfrey and Deputy Commissioner John Arnold explained a revised set of amendments negotiated with Representative Casper and the North Dakota Pharmacists Association. They said the bill largely kept the House policy intact but added technical corrections, narrowed some references in Chapter 19-02, created a separate PBM licensing class, set a delayed effective date for licensing, and established emergency authority so the department could begin building the new division. They also described the proposal to fund the program through existing trust fund resources, PBM license fees, and a transfer of about $1.6 million from the prescription drug transparency program fund, while allowing the department flexibility to hire needed attorneys, pharmacists, and examiners. A major point of discussion was Section 10, which would have required the Attorney General to represent and bear costs for lawsuits related to the bill. Chief Deputy Attorney General Claire Ness said the language was too broad and would go beyond normal constitutional defense work, potentially obligating her office to cover all lawsuits against the commissioner or state under the section. Representative Casper said the intent was only to avoid the Insurance Department having to seek emergency funding for litigation, and both he and department officials said they were open to removing the section or narrowing it. After further discussion, the committee agreed to remove Section 10 from the amendments. The committee then voted 4-0 to adopt the amended amendment package, and then voted 4-0 to give House Bill 1584 a do pass recommendation as amended and refer it to Appropriations. Members noted the bill was still a work in progress, but said the revised version was intended to move the PBM regulation issue forward while continuing discussion in the appropriations process.

Transcript Highlights:

• way as a pass-through PBM, a transparent pass-through PBM, that if those plans or those employers choose
• We do PBMs play a role.
• Our agency works with PBMs.
• way as a pass-through PBM, a transparent pass-through PBM, that if those plans or those employers choose
• Our agency works with PBMs.

Bills: SB65, SB248, SB330, SB378, SB844, SB1330, SB1410, SB1475, SB1476, SB1565, SB1618, SB1623, SJR39, SJR47, SB2084, SB1655, SB1679, SB2174, SB1775, SB1873, SB1204, SB1884, SB1916, SB1937, SB1447, SB1500, SB2007, SB2074, SB1944, SB2018, SB1984, SB2026, SB2045, SB2049, SB2062, SB2112, SB2118, SB2127, SB2134, SB2135, SB2139, SB2154, SB1195

Keywords: SB65, naloxone, Narcan, opioid overdose, overdose reversal, opioid antagonist, emergency opioid antagonist, substance abuse services, harm reduction, public health, overdose prevention, good samaritan, civil immunity, criminal immunity, controlled substances, addiction treatment, fentanyl, opioid crisis, school overdose response, first aid