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      RS 22:1860.3     

  

§1860.3. Reimbursements

            A. A pharmacy benefit manager or person acting on behalf of a pharmacy benefit manager shall not reimburse a pharmacy or pharmacist in this state an amount less than the amount that the pharmacy benefit manager reimburses an affiliate of the pharmacy benefit manager for providing the same services. The amount shall be calculated on a per-unit basis using the same generic product identifier or generic code number.

            B.(1) Any pharmacy or pharmacist who has a contract, either directly or through a pharmacy services administration organization, with a pharmacy benefit manager administering any type of drug or pharmacy benefit plan to provide covered drugs, devices, or services at a contractual reimbursement rate may decline to provide a covered drug, device, or service if the pharmacy or pharmacist will be or is paid less than the acquisition cost for the covered drug, device, or service.

            (2) If the pharmacy or pharmacist declines to provide the drug, device, or service as authorized in this Subsection, then the pharmacy or pharmacist shall provide the customer with adequate information as to where the prescription for the drug, device, or service may be filled.

            (3) No pharmacy benefit manager, pharmacy services administration organization, or any person acting for or on behalf of a pharmacy benefit manager or pharmacy services administration organization shall cancel any contract with the pharmacy or pharmacist, sue for breach of contract, use the decision to decline as a cause for not renewing the contract, or retaliate against or penalize the pharmacy or pharmacist in any way.

            C. The commission of any act prohibited by this Section shall be considered an unfair method of competition and unfair practice or act which shall subject the violator to any and all actions, including investigative demands, private actions, remedies, and penalties, provided for in the Unfair Trade Practices and Consumer Protection Law, R.S. 51:1401 et seq.

            D. Any provision of a contract that is contrary to any provision of this Section shall be null, void, and unenforceable in this state.

            E. Notwithstanding any provision of the law to the contrary, effective January 1, 2025, no pharmacy benefit manager or person acting on behalf of a pharmacy benefit manager shall reimburse a pharmacy or pharmacist in this state an amount less than the acquisition cost for the covered drug, device, or service. The provisions of this Subsection shall apply to only a contracted pharmacist or pharmacy that does not own more than five shares or a five percent interest in a pharmaceutical wholesale group purchasing organization or vendor of any covered drug, device, or service.

            Acts 2018, No. 597, §1, eff. Jan. 1, 2019; Acts 2019, No. 161, §1, eff. June 6, 2019; Acts 2024, No. 768, §1, eff. June 19, 2024.



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