BATON ROUGE = As the 2025 Louisiana legislative session drew to a close, lawmakers passed significant reforms on pharmacy benefit managers (PBMs) with House Bill 264, but another major PBM bill—House Bill 358—died quietly in the Senate, despite strong early momentum.
House Bill 264, sponsored by Rep. Mike Echols (R-Monroe), was designed to increase transparency in how PBMs operate. The legislation bans a practice called “spread pricing,” where PBMs charge health plans more for medications than they reimburse pharmacies, pocketing the difference. It also requires PBMs to pass along all manufacturer rebates to insurance plans or patients, report detailed pricing information to state regulators, and submit to annual audits by the Insurance Commissioner. To protect local pharmacies, HB 264 mandates minimum reimbursement standards and establishes a PBM Advisory Council to monitor the industry’s impact on independent drugstores.
The bill enjoyed broad support throughout the session. It passed both the House and Senate unanimously and cleared its final hurdle when the House voted 100-0 to concur with Senate amendments on June 12. It now awaits the governor’s signature and is expected to become law in early 2026.
House Bill 358, authored by Rep. Dustin Miller (D-Opelousas), took a more aggressive approach. The bill sought to ban PBMs from owning or operating pharmacies in Louisiana starting in 2027.
The House overwhelmingly approved HB 358 in April, and the Senate passed it in late May. But the measure became the subject of fierce industry resistance, most notably from CVS Caremark. In the final days of the session, CVS sent mass text messages to customers across Louisiana, warning that the bill could force the closure of up to 119 CVS pharmacy locations and put more than 2,700 jobs at risk. The company urged residents to contact their legislators and oppose the bill.
The texts sparked a backlash from elected officials. Governor Jeff Landry called the campaign “unethical and manipulative” and asked the state Attorney General to investigate whether CVS had improperly used private patient data to lobby against the legislation.
Despite its early momentum, HB 358 was never brought to a final Senate vote before the session adjourned, allowing the bill to quietly expire.
But HB 358’s defeat may only be temporary. Governor Landry has suggested he may call a special session later this year to revisit the ownership issue and other proposals aimed at curbing PBM influence in Louisiana’s pharmacy market.
