The Louisiana Legislature is poised to finalize House Bill 264, landmark legislation aimed at bringing greater transparency and fairness to pharmacy benefit managers (PBMs), the middlemen who negotiate pricing between drug manufacturers, insurers, and pharmacies.
HB 264, authored by Rep. Michael Echols (R-Monroe), sailed through the House on May 22 with an 86–0 vote and then passed the Senate June 9 by a unanimous 38–0 margin following floor amendments. As of June 10, it is scheduled for final concurrence in the House to approve the Senate’s changes before heading to the governor.
HB 264 significantly expands the powers of the Louisiana Department of Insurance. It will allow the commissioner to:
Review PBM compensation programs to ensure fair reimbursement rates for pharmacies
Examine PBM records to verify pricing, rebate management, and administrative fees
Prohibit spread pricing and “patient steering,” ensuring PBMs can’t hide costs or push patients to certain pharmacies
Mandate PBMs pass manufacturer rebates fully to health plans and require annual transparency reports filed by March 1
A new Pharmacy Benefit Manager Enforcement Fund will be established, funded through fines and civil penalties collected by the Department of Insurance or Attorney General. The fund will support enforcement operations and potentially return unused funds to policyholders.
According to the Legislative Fiscal Office, HB 264 is expected to increase state expenditures by approximately $90,000 annually to cover the costs of reviewing PBM records. While proponents argue the reforms could help lower drug costs for consumers and bolster pharmacy operations, opponents in the PBM industry warn the measures may unnecessarily drive up premiums and hinder PBMs’ ability to negotiate lower prices
With the House set to vote on concurrence June 11, the bill appears on course to reach Governor Landry’s desk soon. If signed, the majority of HB 264’s provisions would take effect January 1, 2026, with full enforcement beginning in 2027 .
