Video & Transcript Research : 'formulary'
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LA
Transcript Highlights:
- We have generic first, and we do cover biosimilars on our formulary.
- from formulary until the renewal date.
- Our formulary has right under 33,000 generic and biosimilars on the formulary, less than 5,000.
- So a lot of the negotiations around rebates are about formulary placement.
- a generic or biosimilar on the drug formulary.
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
NM
New Mexico 2026 Regular Session
Senate - Health and Public Affairs Feb 6th, 2026 at 05:13 pm
Senate Health & Public Affairs
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
NM
New Mexico 2026 Regular Session
House - Health and Human Services Feb 16th, 2026 at 09:04 am
House Health & Human Services
Transcript Highlights:
- drug, I'm looking at line 3, that is biosimilar to the chronic maintenance drug is added to the formulary
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
NM
New Mexico 2026 Regular Session
Senate - Health and Public Affairs Feb 4th, 2026 at 06:25 pm
Senate Health & Public Affairs
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
MN
Transcript Highlights:
- In 2019, the legislature removed the weight loss restriction from the drug formulary.
- restriction from the drug formulary. restriction from the drug formulary.
- I'm here to urge you to reject the proposed Medicaid changes to the Medicaid formulary that would prohibit
- I'm also here to urge you to reject the proposed changes to the Medicaid formulary that would prohibit
- that would to the Medicaid formulary that would prohibit<00:57:43.400>
cost <00:57:43.720>
Keywords:
opioid use disorder, OUD, medication-assisted treatment, MAT, pharmacist prescribing, pharmacy practice, controlled substances, Schedule III, Schedule IV, Schedule V, DEA registration, Board of Pharmacy, substance use disorder, addiction treatment, buprenorphine, naltrexone, harm reduction, prescription authority, pharmacist intern, Minnesota pharmacy law
MN
Minnesota 2025-2026 Regular Session
Committee on Commerce and Consumer Protection - 03/11/25
Commerce and Consumer Protection
Transcript Highlights:
- <00:40:20.960>
it going to be changes in the formulary it going to be changes in the formulary - <00:43:13.119>
um going to be a change in the formulary um going to be a change in the formulary - <00:47:07.640>
is get onto a PBM or planed formulary is get onto a PBM or planed formulary - <00:47:35.040>
they other drugs on the formulary but they other drugs on the formulary but - so low copay rebate or low formulary so low copay rebate or low formulary pick<00:53:41.119>
MN
Minnesota 2025-2026 Regular Session
House Health Finance and Policy Committee 3/19/25
Health Finance and Policy
Transcript Highlights:
- <00:37:12.480>
And drugs onto their formularies. And drugs onto their formularies. - formulary today? formulary today? Mr.<00:41:11.359>
Anderson. - every quarter we change the formulary. every quarter we change the formulary.
- limit this would freeze your formulary. limit this would freeze your formulary.
- their formulary or placing a formulary their formulary or placing a formulary drug<00:49:04.960>
FL
Florida 2026 4th Special Session
February 16, 2026 - 01:30 PM
Transcript Highlights:
- 190 FIRSTLY MANDATE IMPLEMENTATION FOR FORMULARY STATE GROUP INSURANCE PROGRAM BEGINNING
- or no formulary at all.
- So by doing that, we now can exclude certain drugs from a formulary.
- This allows the DMS to create a formulary.
- Especially, I want to reiterate that creating a formulary is a responsible thing for us to do.
Summary:
The State Administration Budget Subcommittee met to consider four conforming committee bills tied to the proposed 2026-27 House General Appropriations Act. Rep. Maggard presented PCB SAB 26-04, the annual retirement bill, which updates Florida Retirement System contribution rates based on the annual actuarial study and was said to produce a $31.7 million state savings. He also presented PCB SAB 26-02, which addresses collective bargaining impasses for state employees by tying resolution to spending decisions in the appropriations act or implementing legislation. Both bills drew brief questions, mainly from Rep. Gantt, and both passed favorably on roll call.
Rep. Miller presented PCB SAB 26-03, which reorganizes state audit functions and creates the Florida Accountability Office, consolidating legislative audit work into four divisions and adding whistleblower protections and reporting requirements. Rep. Gantt asked whether the bill changed the use of outside auditors and whether it had a fiscal impact; Miller said the work would be absorbed within existing resources and that the Legislature would retain responsibility. A taxpayer witness supported the bill and urged stronger local-government audit standards and broader whistleblower coverage. The bill passed favorably.
Rep. Abbott presented PCB SAB 26-01, a broader appropriations conforming bill focused on the State Employee Health Insurance Trust Fund, prescription drug formulary changes, a health insurance assessment on agencies and vacant positions, the $3 traffic violation surcharge for the State Law Enforcement Radio System, Capitol complex space management, and changes to the Office of Supplier Diversity. Much of the discussion centered on whether a closed formulary would make medications harder to obtain, with Abbott saying prior authorization would still allow access and that the change was needed to control costs and protect the trust fund. Rep. Gantt and Rep. Robinson raised concerns about employee health benefits and the repeal of supplier diversity provisions, arguing the committee lacked data on the impact to minority- and women-owned businesses; Abbott said the changes would still allow small businesses to compete and that the bill was intended to save money and modernize procurement. PCB SAB 26-01 also passed favorably, and the meeting adjourned after all agenda items were reported out.
NH
New Hampshire 2025 Regular Session
JLCAR Administrative Rules (04/18/2025)
Transcript Highlights:
- the board to do rulemaking for the formulary either.
- <00:09:51.120>
You'll around the board's formulary. You'll around the board's formulary. - <00:10:02.000>
from explicitly exempt the formulary from explicitly exempt the formulary from - Uh the statute just formulary either.
- But um that is the particular formulary.
Summary:
The committee first approved the minutes from the prior meeting and adopted the consent calendar without objection. It then postponed the Board of Licensed Dieticians item until next month after granting a waiver, and also postponed the Board of Accountancy item to next month so the agency could respond.
The Board of Registry and Optometry received conditional approval. Staff noted the board had addressed editorial comments, but flagged one substantive issue involving the drug formulary and whether it should be exempt from rulemaking requirements; the committee agreed to add that as a legislative suggestion for later review. The Department of Natural and Cultural Resources interim rule drew more discussion, focused on a provision regulating kindling size for Category 3 fires. Staff and committee members questioned whether the agency had authority over Category 3 fires under the statute, but agency representatives said the interim rules were needed because the prior rules had expired and forest rangers lacked enforcement authority while final rulemaking was pending. The committee ultimately granted conditional approval to interim rule 25-4, with one member voting against it over concerns about consistency with the law.
The Board of Examiners’ Dental 304 rules were presented next. The agency explained that it had revised the rules to address prior committee concerns about anesthesia and sedation for children, including creating a pathway for oral surgeons and dentist anesthesiologists to obtain exemptions for under-13 patients, setting a 20-patient-every-two-years threshold for certain permits, adding pediatric minimal sedation permitting, and loosening moderate sedation rules for pediatric dentists. Members also discussed whether the rules were compatible with House Bill 470, and staff said they appeared compatible and would not require additional rulemaking. The committee then approved the dental rules, and after that it adjourned after announcing it would cancel the continued meeting and take up remaining business next month.
FL
Florida 2025 Regular Session
March 20, 2025 - 11:30 AM
Transcript Highlights:
- A drug formulary is simply a list of available drugs covered by the health plan.
- Formulary management is used to manage which drugs are included in formulary in order to manage costs
- formulary options for your consideration based on our... ...wanted to propose some formulary options
- The formulary could be that, well, no, the doctor has to pick between one of those two.
- the drugs from the formulary.
Summary:
The Budget Committee met with a quorum and took up several bills. HB 677, relating to state-covered fertility preservation for employees undergoing cancer treatment, was introduced as coverage for egg and sperm preservation for up to three years, with an estimated fiscal impact of about $813,000. After brief questions and no public testimony or amendments, the bill passed unanimously and was reported favorably. The committee then considered CS/HB 59, which would reform Florida’s wrongful incarceration compensation process by extending the filing deadline from 90 days to two years, removing the clean-hands requirement, and allowing exonerees to choose between the state compensation process and a civil lawsuit; it was supported by the City of Flagler Beach and passed unanimously. CS/HB 1313, which recreates the Resilient Florida Trust Fund in the Department of Environmental Protection before its scheduled termination in 2025, also passed unanimously after supportive testimony from advocacy groups.
The committee received a lengthy presentation from the Department of Management Services on the State Group Insurance Program and the recent Revenue Estimating Conference. The presentation covered enrollment, revenues and expenditures, rising medical and pharmacy costs, emergency room utilization, GLP-1 drug spending, and options for tighter formulary and utilization management. Members asked about ER cost growth, GLP-1 coverage and copays, PBM oversight and potential conflicts, avoidable ER visits, cancer screening claims, dental and vision costs, specialty drug biosimilars, and possible savings from more restrictive pharmacy models. DMS said it would follow up on several questions and noted ongoing work on cancer coordination, preventive screening, biomarker testing, and a proposed member-facing benefits platform.
The committee also heard extensive testimony on HB 301, which would raise sovereign immunity caps from $200,000 per person and $300,000 per incident to $1 million and $3 million, align limitations periods with private claims, and allow government entities to settle above the caps without a claims bill. Local governments, school-related entities, and county and city associations opposed the bill, warning of major fiscal impacts, higher insurance costs, and pressure on services; several speakers urged smaller increases or a tiered approach. Proponents, including families affected by catastrophic injury or death, argued the current caps are too low and the claims bill process is inefficient and unfair. After debate, the bill passed on a recorded vote, with some members voting no, and was reported favorably.
NH
New Hampshire 2025 Regular Session
JLCAR Administrative Rules (04/18/2025)
Transcript Highlights:
- the board to do rulemaking for the formulary either.
- <00:09:51.120>
You'll around the board's formulary. You'll around the board's formulary. - <00:10:02.000>
from explicitly exempt the formulary from explicitly exempt the formulary from - Uh the statute just formulary either.
- But um that is the particular formulary.
Summary:
The committee opened with routine business, approving the prior meeting minutes and adopting the consent calendar without objection. It then postponed the Board of Licensed Dieticians and the Board of Accountancy items to next month, with a waiver granted for the dieticians item so it could be carried over. The committee also noted that the Department of Natural and Cultural Resources interim rule would be discussed further, and staff flagged a specific concern about authority over kindling size for category 3 fires under NCR 5601.04.
The Board of Registry and Optometry received conditional approval. Staff said the board had addressed editorial comments, but raised one substantive issue about the drug formulary: the statute requires posting it online but does not clearly exempt it from rulemaking, suggesting a possible legislative carveout may be needed. The committee agreed to add that issue to a list of legislative suggestions for later consideration.
The DNCR interim fire rule was the main contested item. Committee members and staff discussed whether the rule exceeded authority by regulating kindling for category 3 fires, and the agency explained that the regular rules had expired and interim rules were needed quickly for public safety and permit enforcement. The committee ultimately granted conditional approval on the interim rule 25-4, with the understanding that the agency would continue regular rulemaking and address the objection.
The Board of Examiners’ dental rules were then reviewed. The agency explained that it revised the rules to address prior concerns about anesthesia and sedation for children, including a pathway for oral surgeons and dentist anesthesiologists to obtain exemptions for under-13 patients, a pediatric minimal sedation permit, and a moderate sedation permit with pediatric qualification. Members also discussed whether the rules were consistent with House Bill 470; staff and members concluded they appeared compatible and would not require additional rulemaking. The committee approved the dental rules, and then adjourned after no further business.
MN
Minnesota 2025 1st Special Session
Committee on Health and Human Services - 03/25/25
Health and Human Services
Transcript Highlights:
- years and they said that my formulary years and they said that my formulary changed<00:38:41.119
- Hold them the formulary midyear.
- So instead of the formularies.
- <01:21:04.560>
formulary <01:21:05.640>placement metric for formulary formulary placement - product be preferred on the formulary. product be preferred on the formulary.
AR
Arkansas 2026 1st Special Session
ALC-STATE INSURANCE PROGRAMS OVERSIGHT SUBCOMMITTEE Feb 18th, 2026
ALC-STATE INSURANCE PROGRAMS OVERSIGHT SUBCOMMITTEE
Transcript Highlights:
- Item number two is the December 2025 pharmacy formulary recommendations.
- Next item up is the January 2026 pharmacy formulary recommendations.
- Next item up is the January 2026 pharmacy formulary recommendations.
- Moving to the February 2026 pharmacy formulary recommendations.
- Yeah, and I certainly understand. ...or driving the formulary design.
Summary:
The State Insurance Programs Oversight Subcommittee met to review and approve several State Board of Finance actions related to employee benefits and pharmacy coverage. Grant Wallace, Director of the Employee Benefits Division and Office of Property Risk, presented a $280,000 Boston Consulting Group contract to help develop a third-party administration RFP, and the committee approved it. The committee then considered pharmacy formulary recommendations for December 2025, January 2026, and February 2026, along with February 2026 medical drug recommendations.
Across the formulary items, Wallace explained that some drugs were being removed from prior authorization requirements, some were being updated to reflect FDA guidance or dosage changes, and others were being left not covered because lower-cost alternatives already exist or clinical evidence was insufficient. Notable changes included removing Skyrizi and Renvoke from the pharmacy formulary in favor of lower-cost biosimilars, adding certain generics, and adding a subcutaneous version of Keytruda for faster administration. The committee approved each set of recommendations by motion and voice vote.
Members also raised broader questions about the impact of new drug-pricing programs such as Trump RX, Cost Plus, and other manufacturer discount efforts, as well as concerns about PBM oversight and whether Navitus is complying with state law. Wallace said the department is still studying those issues and working with Navitus to assess pricing opportunities and compliance. Senator Boyd also asked about whether affiliated pharmacies are being paid more than independent pharmacies, noting he had not received a prior response; Wallace was asked to follow up. The meeting concluded with no further business and adjournment.
AR
Arkansas 2026 Regular Session
ALC-STATE INSURANCE PROGRAMS OVERSIGHT SUBCOMMITTEE Feb 18th, 2026
ALC-STATE INSURANCE PROGRAMS OVERSIGHT SUBCOMMITTEE
Transcript Highlights:
- Item number two is the December 2025 pharmacy formulary recommendations.
- The capsule is currently on formulary, but is soon to be discontinued.
- Next item up is the January 2026 pharmacy formulary recommendations.
- Next item up is the January 2026 pharmacy formulary recommendations.
- Moving to the February 2026 pharmacy formulary recommendations.
Summary:
The State Insurance Programs Oversight Subcommittee met to review and approve several Employee Benefits Division (EBD) and pharmacy formulary actions. Grant Wallace, director of EBD and the Office of Property Risk, presented a $280,000 Boston Consulting Group contract to help develop the third-party administration RFP, and the committee approved it. The committee also approved the December 2025, January 2026, and February 2026 pharmacy formulary recommendations, along with February 2026 medical drug recommendations.
The formulary changes focused on removing prior authorization for injectable migraine CGRPs, replacing a discontinued capsule with a tablet, updating items for FDA guidance, and leaving some drugs not covered when lower-cost alternatives or insufficient efficacy data existed. For February 2026, EBD recommended removing Skyrizi and Renvoke in favor of lower-cost biosimilars and other alternatives, re-tiering several drugs to encourage generics, adding an anti-seizure medication developed by the Department of Defense, and adding a subcutaneous version of Keytruda for faster administration. The medical drug list similarly shifted toward biosimilars and aligned coverage for Skyrizi and Renvoke across pharmacy and medical settings.
Members raised broader questions about the impact of new pharmaceutical discount programs such as Trump RX and Mark Cuban Cost Plus, as well as concerns about PBM compliance and whether Navitus might be violating state law or paying affiliate pharmacies more than independent pharmacies. Wallace said the new programs and their effects were still being studied, that EBD was working with Navitus to evaluate pricing opportunities, and that Navitus had said it was in compliance with Rule 118, though additional research and auditing were underway. All items were approved by voice vote, and the meeting adjourned after no further business.
NH
New Hampshire 2025 Regular Session
Senate Health and Human Services (01/15/2025)
Health and Human Services
Transcript Highlights:
- They should carefully search their formularies before simply responding to a drug manufacturer coupon
- So yes, PBMs do create formularies where we pit drug manufacturers against each other.
- So yes, PBMs do create formularies where we pit drug manufacturers against each other.
- The biggest tool we have is the formulary, and if there are things happening that disrupt that formulary
- that formulary happening that disrupt that formulary that<01:40:45.199>
shifts <01:40:45.639><
KY
Kentucky 2025 Regular Session
House Standing Committee on Banking & Insurance (3-12-25)
Transcript Highlights:
- to ensure that insurance formularies to ensure that their<00:17:10.600>
patient <00:17:11.000> - they decide which drugs are formularies they decide which drugs are covered<00:17:20.880>
and - or placed on higher tiers formularies or placed on higher tiers making<00:19:06.200>
them <00: - and own the pharmacies often formularies and own the pharmacies often where<00:19:45.679>
their drugs to be placed on our formularies drugs to be placed on our formularies that's<00:33:23.720>
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.
NH
New Hampshire 2026 Regular Session
Senate Health and Human Services (02/04/2026)
Health and Human Services
Transcript Highlights:
- formularies under health benefit plans. formularies under health benefit plans.
- ,<00:22:27.919>
they plan with a certain formulary, they plan with a certain formulary, they - It does not prohibit formulary costs.
- [clears throat] formulary.
- to maintain 36 separate formularies. to maintain 36 separate formularies. [snorts] Thank you.
MN
Minnesota 2025-2026 Regular Session
MA cover weight-loss drugs 3/25/26
Minnesota House Floor Meeting
Transcript Highlights:
- In 2019 in 2021, the legislature removed the weight loss restriction from the drug formulary.
- <00:03:44.360>
At restriction from the drug formulary. - At restriction from the drug formulary.
- med changes to the Medicaid formulary med changes to the Medicaid formulary that<00:06:36.680>
- Chair. formulary. Thank you, Mr. Chair.
LA
Louisiana 2026 Regular Session
Labor and Industrial Relations May 7th, 2026
Transcript Highlights:
- And then there's a formulary, which I was Representative Chasson.
- formulary that could be used for auto approval.
- And the formulary—Nevada's not costing them a dime because we give the formulary.
- Not the formulary. Okay.
- were not covered under the Texas formulary.
Summary:
The House Labor and Industrial Relations Committee met on May 7, 2026, and first deferred several measures, including House Bill 460, Senate Bill 322, Senate Bill 32, Senate Bill 22, and House Bill 561. The committee then took up House Bill 819 by Chairman Cruz, which would replace Louisiana’s current workers’ compensation medical treatment schedule with the Official Disability Guidelines (ODG) by MCG as the primary guideline, while keeping the existing variance and appeal process. Cruz and MCG representative Troy Prevo argued that ODG is more comprehensive, updated more frequently, and used in many states, and said it could reduce delays, disability duration, and costs. Dr. Jason Picard, the state medical director, testified that Louisiana already uses ODG as a secondary reference in many cases because the state schedule lacks coverage for some body parts and treatments, and said the bill would not otherwise change the appeals process or care delivery.
Committee members focused heavily on whether the bill would delay care or improve it. Several members questioned the private-company nature of ODG, the $400 annual subscription cost, and whether Louisiana doctors would be forced to rely on an out-of-state guideline. Rep. Glorioso and others raised concerns about preauthorization delays and proposed amendments to create tacit approval when treatment follows the schedule, require payment within 30 days, and make the carrier prove by clear and convincing evidence that care was not medically necessary to challenge it. Chairman Cruz said he was willing to work with those ideas, and the committee also discussed adding an on-ramp or legacy language so current patients would not be disrupted.
Opposition testimony came from injured-worker advocates and representatives of medical and labor groups, including Joseph Jola St. and Robin Krumholt. They argued that Louisiana’s current guidelines are already working, that rates have fallen over time, and that the real problem is delay in approval rather than the content of the schedule. They said ODG is overly rigid, cost-driven, and can lead to denials that shift costs to workers, Medicaid, or private health insurance. They urged the committee to keep Louisiana’s existing system and instead adopt tacit approval under current law. The bill was still under discussion at the close of the transcript, with amendments being read and no final vote shown.
MN
Minnesota 2025 1st Special Session
Minnesota House passes HF2403, the commerce policy bill 4/29/25
Minnesota House Floor Meeting
Transcript Highlights:
- And these Medicare Advantage plans can also change their formulary, their drug formulary, which is something
- we've talked about a lot on this floor, how unfair it is when you're on a drug and suddenly the formulary
- ,<00:17:05.120>
their <00:17:05.439>drug <00:17:05.760>formulary, <00:17:06.480>< - c> which formulary, their drug formulary, which formulary, their drug formulary, which is<00:17:06.880
- on a drug and suddenly the formulary on a drug and suddenly the formulary gets<00:17:13.120>