Pharmacy Benefit Prompt Pay Act; revise various existing and create additional provisions related to.

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To: Public Health and
Welfare
MISSISSIPPI LEGISLATURE REGULAR SESSION 2026

By: Senator(s) Parks

SENATE BILL NO. 2575

AN ACT TO AMEND SECTION 73-21-151, MISSISSIPPI CODE OF 1972, 1
TO REFERENCE NEW SECTIONS IN THE PHARMACY BENEFIT PROMPT PAY ACT; 2
TO AMEND SECTION 73-21-153, MISSISSIPPI CODE OF 1972, TO DEFINE 3
AND REVISE TERMS UNDER THE PHARMACY BENEFIT PROMPT PAY ACT; TO 4
AMEND SECTION 73-21-155, MISSISSIPPI CODE OF 1972, TO REVISE THE 5
METHOD OF DETERMINING REIMBURSEMENT TO A PHARMACIST OR PHARMACY BY 6
A PHARMACY BENEFIT MANAGER OR PHARMACY SERVICES ADMINISTRATIVE 7
ORGANIZATION (PSAO) FOR THE DISPENSING OF PRESCRIPTION DRUGS AND 8
OTHER PRODUCTS AND SUPPLIES; TO AMEND SECTION 73-21-156, 9
MISSISSIPPI CODE OF 1972, TO REQUIRE PHARMACY BENEFIT MANAGERS TO 10
PROVIDE A REASONABLE ADMINISTRATIVE APPEAL PROCEDURE TO ALLOW 11
PHARMACIES TO CHALLENGE A REIMBURSEMENT FOR A SPECIFIC DRUG OR 12
DRUGS AS BEING BELOW THE REIMBURSEMENT RATE REQUIRED BY THE 13
PRECEDING PROVISION; TO PROVIDE THAT IF THE APPEAL IS UPHELD, THE 14
PHARMACY BENEFIT MANAGER SHALL MAKE THE CHANGE IN THE PAYMENT TO 15
THE REQUIRED REIMBURSEMENT RATE; TO AMEND SECTION 73-21-157, 16
MISSISSIPPI CODE OF 1972, TO REQUIRE THE PSAO TO BE LICENSED WITH 17
THE MISSISSIPPI BOARD OF PHARMACY (BOARD); TO CREATE NEW SECTION 18
73-21-158, MISSISSIPPI CODE OF 1972, TO PROHIBIT A PHARMACY 19
BENEFIT MANAGER FROM ENGAGING IN SPREAD PRICING; TO AMEND SECTION 20
73-21-161, MISSISSIPPI CODE OF 1972, TO PROHIBIT A PHARMACY, 21
PHARMACY BENEFIT MANAGER OR PHARMACY BENEFIT MANAGER AFFILIATES 22
FROM STEERING; TO CREATE NEW SECTION 73-21-162, MISSISSIPPI CODE 23
OF 1972, TO PROHIBIT PHARMACY BENEFIT MANAGERS, PHARMACY BENEFIT 24
MANAGER AFFILIATES AND PSAOS FROM RETALIATING AGAINST A PHARMACY 25
OR PHARMACIST; TO AMEND SECTION 73-21-163, MISSISSIPPI CODE OF 26
1972, TO AUTHORIZE THE BOARD, FOR THE PURPOSES OF CONDUCTING 27
INVESTIGATIONS, TO CONDUCT EXAMINATIONS OF A PHARMACY BENEFIT 28
MANAGER OR PSAO AND TO ISSUE SUBPOENAS TO OBTAIN DOCUMENTS OR 29
RECORDS THAT IT DEEMS RELEVANT TO THE INVESTIGATION; TO CREATE NEW 30
SECTION 73-21-165, MISSISSIPPI CODE OF 1972, TO REQUIRE PHARMACY 31
BENEFIT MANAGERS TO ANNUALLY REPORT TO THE BOARD CERTAIN 32
INFORMATION ABOUT REBATES AND OTHER PAYMENTS RECEIVED FROM 33
PHARMACEUTICAL MANUFACTURERS; TO CREATE NEW SECTION 73-21-167, 34
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MISSISSIPPI CODE OF 1972, TO CREATE THE MISSISSIPPI SPECIALTY DRUG 35
COMMITTEE AND DIRECT IT TO DEVELOP A LIST OF PRESCRIPTION DRUGS 36
THAT MEET THE CRITERIA FOR SPECIALTY DRUG DESIGNATION TO ASSIST 37
WITH PATIENT ACCESS, TRANSPARENCY AND RESPONSIBLE COST MANAGEMENT; 38
TO CREATE NEW SECTION 73-21-211, MISSISSIPPI CODE OF 1972, TO 39
CREATE THE PHARMACY FAIR COMPETITION ACT; TO CREATE NEW SECTION 40
73-21-213, MISSISSIPPI CODE OF 1972, TO PROVIDE LEGISLATIVE 41
FINDINGS; TO CREATE NEW SECTION 73-21-215, MISSISSIPPI CODE OF 42
1972, TO PROHIBIT A PHARMACY BENEFIT MANAGER FROM ACQUIRING DIRECT 43
OR INDIRECT INTEREST IN, OR OTHERWISE HOLDING, DIRECTLY OR 44
INDIRECTLY, A PHARMACY PERMIT FOR THE RETAIL SALE OF DRUGS OR 45
MEDICINES IN THIS STATE; TO AUTHORIZE THE BOARD TO ISSUE A LIMITED 46
USE PERMIT UPON A DETERMINATION THAT CERTAIN RARE, ORPHAN OR 47
LIMITED DISTRIBUTION DRUGS ARE OTHERWISE UNAVAILABLE IN THE 48
MARKET; TO CREATE NEW SECTION 73-21-217, MISSISSIPPI CODE OF 1972, 49
TO REQUIRE THE BOARD TO CONDUCT ASSESSMENTS OF EACH ACTIVE RETAIL 50
PHARMACY PERMITS AND TO PROVIDE WRITTEN NOTICE TO PERMIT HOLDERS 51
THAT THE BOARD REASONABLY BELIEVES WILL VIOLATE THIS ACT; TO AMEND 52
SECTION 25-15-301, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT THE 53
EXECUTIVE DIRECTOR OF THE BOARD, OR HIS OR HER DESIGNEE, SHALL BE 54
A MEMBER OF THE EVALUATION COMMITTEE WHEN THE PROPOSAL FOR 55
EVALUATION IS FOR PHARMACY BENEFITS OR THE MANAGEMENT THEREOF; TO 56
AMEND SECTION 25-15-303, MISSISSIPPI CODE OF 1972, TO ADD THE 57
EXECUTIVE DIRECTOR OF THE BOARD, OR HIS OR HER DESIGNEE; TO THE 58
STATE AND SCHOOL EMPLOYEES HEALTH INSURANCE MANAGEMENT BOARD; AND 59
FOR RELATED PURPOSES. 60
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 61
SECTION 1. Section 73-21-151, Mississippi Code of 1972, is 62
amended as follows: 63
73-21-151. Sections 73-21-151 through * * * 73-21-167 shall 64
be known as the "Pharmacy Benefit Prompt Pay Act." 65
SECTION 2. Section 73-21-153, Mississippi Code of 1972, is 66
amended as follows: 67
73-21-153. For purposes of Sections 73-21-151 through * * * 68
73-21-167, the following words and phrases shall have the meanings 69
ascribed herein unless the context clearly indicates otherwise: 70
(a) "Board" means the * * * Mississippi Board of 71
Pharmacy. 72
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(b) "Clean claim" means a completed billing instrument, 73
paper or electronic, received by a pharmacy benefit manager from a 74
pharmacist or pharmacies or the insured, which is accepted and 75
payment remittance advice is provided by the pharmacy benefit 76
manager. A clean claim includes resubmitted claims with 77
previously identified deficiencies corrected. 78
( * * *c) "Commissioner" means the Mississippi 79
Commissioner of Insurance. 80
( * * *d) "Day" means a calendar day, unless otherwise 81
defined or limited. 82
(e) "Drug" means that term as defined in Section 83
73-21-73. 84
( * * *f) "Electronic claim" means the transmission of 85
data for purposes of payment of covered prescription drugs, other 86
products and supplies, and pharmacist services in an electronic 87
data format specified by a pharmacy benefit manager and approved 88
by the department. 89
( * * *g) "Electronic adjudication" means the process 90
of electronically receiving * * * and reviewing an electronic 91
claim and either accepting and providing payment remittance advice 92
for the electronic claim or rejecting * * * the electronic claim. 93
( * * *h) "Enrollee" means an individual who has been 94
enrolled in a pharmacy benefit management plan or health insurance 95
plan. 96
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( * * *i) "Health insurance plan" means benefits 97
consisting of prescription drugs, other products and supplies, and 98
pharmacist services provided directly, through insurance or 99
reimbursement, or otherwise and including items and services paid 100
for as prescription drugs, other products and supplies, and 101
pharmacist services under any hospital or medical service policy 102
or certificate, hospital or medical service plan contract, 103
preferred provider organization agreement, or health maintenance 104
organization contract offered by a health insurance issuer. 105
(j) "Network pharmacy" means a pharmacy licensed by the 106
board that provides pharmacy services to Mississippi consumers and 107
has a contract with a pharmacy benefit manager to provide covered 108
drugs at a negotiated reimbursement rate. 109
(k) "Payment remittance advice" means the claim detail 110
that the pharmacy receives when successfully processing an 111
electronic or paper claim. The claim detail shall contain, but is 112
not limited to: 113
(i) The amount that the pharmacy benefit manager 114
or PSAO will reimburse for product ingredient; and 115
(ii) The amount that the pharmacy benefit manager 116
or PSAO will reimburse for product dispensing fee; and 117
(iii) The amount that the pharmacy benefit manager 118
or health insurance plan dictates the patient must pay. 119
( * * *l) "Pharmacist * * *" and "pharmacy" * * * shall 120
have the same definitions as provided in Section 73-21-73. 121
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(m) "Pharmacy acquisition cost" means the amount that a 122
pharmaceutical wholesaler charges for a pharmaceutical product as 123
listed on the pharmacy's billing invoice. 124
( * * *n) "Pharmacy benefit manager" * * * means an 125
entity that provides pharmacy benefit management services. The 126
term "pharmacy benefit manager" shall not include: 127
(i) An insurance company unless the insurance 128
company is providing services as a pharmacy benefit manager * * *, 129
in which case the insurance company shall be subject to * * * this 130
act only for those pharmacy benefit manager services * * *; and 131
(ii) The Mississippi Division of Medicaid or its 132
contractors when performing pharmacy benefit manager services for 133
the Division of Medicaid. 134
( * * *o) "Pharmacy benefit manager affiliate" 135
means * * * an entity that directly or indirectly * * * owns or 136
controls, is owned or controlled by, or is under common ownership 137
or control with a pharmacy benefit manager. 138
( * * *p) "Pharmacy benefit management plan" * * * 139
means an arrangement for the delivery of pharmacist's services in 140
which a pharmacy benefit manager undertakes to administer the 141
payment or reimbursement of any of the costs of pharmacist's 142
services, drugs or devices. 143
(q) "Pharmacy benefit management services" includes, 144
but is not limited to, the following services, which may be 145
provided either directly or through outsourcing or contracts: 146
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(i) Adjudicating drug claims or any portion of the 147
transaction. 148
(ii) Contracting with retail and mail pharmacy 149
networks. 150
(iii) Establishing payment levels for pharmacies. 151
(iv) Developing formularies or drug lists of 152
covered therapies. 153
(v) Providing benefit design consultation. 154
(vi) Managing cost and utilization trends. 155
(vii) Contracting for manufacturer rebates. 156
(viii) Providing fee-based clinical services to 157
improve member care. 158
(ix) Third-party administration. 159
(x) Sponsoring or providing cash discount cards as 160
defined in Section 83-9-6.1, and also electronic discount cards. 161
(r) "Pharmacist services" means products, goods and 162
services, or any combination of products, goods and services, 163
provided as part of the practice of pharmacy. 164
(s) "Pharmacy services administrative organization" or 165
"PSAO" means any entity that contracts with a pharmacy or 166
pharmacist to assist with third-party payer interactions and that 167
may provide a variety of other administrative services, including, 168
but not limited to, contracting with third-party payers or 169
pharmacy benefit managers on behalf of pharmacies and providing 170
pharmacies or pharmacists with credentialing, billing, audit, 171
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general business and analytic support. A covered entity as defined 172
in 42 USC § 256b, including its pharmacy or the transactions 173
related to the 340B drug discount program of any pharmacy 174
contracted with the participating covered entity to dispense drugs 175
purchased through the 340B drug discount program, shall not be 176
considered to be a pharmacy services administrative organization. 177
( * * *t) "Plan sponsors" means the employers, 178
insurance companies, unions and health maintenance organizations 179
that contract, either directly or indirectly, with a pharmacy 180
benefit manager for delivery of prescription drugs and/or 181
services. 182
(u) "Proprietary information" means information on 183
pricing, costs, revenue, taxes, market share, negotiating 184
strategies, customers and personnel that is held by a pharmacy 185
benefit manager or PSAO and used for its business purposes. 186
(v) "Rebate" means any and all payments and price 187
concessions that accrue to a pharmacy benefit manager or its plan 188
sponsor client, directly or indirectly, including through an 189
affiliate, subsidiary, third party or intermediary, including 190
off-shore group purchasing organizations, from a pharmaceutical 191
manufacturer, its affiliate, subsidiary, third party or 192
intermediary, including, but not limited to, payments, discounts, 193
administration fees, credits, incentives, price concessions, or 194
penalties associated directly or indirectly in any way with claims 195
administered on behalf of a plan sponsor. 196
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(w) "Spread pricing" means any amount charged or 197
claimed by a pharmacy benefit manager or PSAO in excess of the 198
ingredient cost for a dispensed prescription drug plus dispensing 199
fee paid directly or indirectly to any pharmacy, pharmacist, or 200
other provider on behalf of the health benefit plan. 201
( * * *x) "Uniform claim form" means a form prescribed 202
by rule by the * * * board * * *; however, for purposes of * * * 203
this act, the board shall adopt the same definition or rule where 204
the State Department of Insurance has adopted a rule covering the 205
same type of claim. The board may modify the terminology of the 206
rule and form when necessary to comply with the provisions 207
of * * * this act. 208
(y) "Wholesale acquisition cost" means the wholesale 209
acquisition cost of the drug as defined in 42 USC § 210
1395w-3a(c)(6)(B). 211
SECTION 3. Section 73-21-155, Mississippi Code of 1972, is 212
amended as follows: 213
73-21-155. (1) Reimbursement * * * to a pharmacist or 214
pharmacy by a pharmacy benefit manager or PSAO for the dispensing 215
of prescription drugs and other products and supplies * * * shall 216
be a net amount not less than the greater of: 217
(a) The total reimbursement paid to its pharmacy 218
benefit manager affiliate; or 219
(b) The total reimbursement paid by the Mississippi 220
Division of Medicaid in its pharmacy reimbursement methodology. 221
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* * * 222
( * * *2) (a) All benefits payable * * * from a pharmacy 223
benefit * * * manager or PSAO shall be paid within seven (7) days 224
after receipt of * * * a clean electronic claim where * * * the 225
claim was electronically adjudicated, and shall be paid within 226
thirty-five (35) days after receipt of due written proof of a 227
clean claim where claims are submitted in paper format. 228
Benefits * * * are overdue if not paid within seven (7) days or 229
thirty-five (35) days, whichever is applicable, after the pharmacy 230
benefit manager receives a clean claim containing necessary 231
information essential for the pharmacy benefit manager to 232
administer preexisting condition, coordination of benefits and 233
subrogation provisions under the plan sponsor's * * * plan. * * * 234
( * * *b) * * * If an electronic claim is denied, the 235
pharmacy benefit manager shall * * * notify the pharmacist or 236
pharmacy * * * within seven (7) days of the reasons why the claim 237
or portion thereof is not clean and will not be paid and what 238
substantiating documentation and information is required to 239
adjudicate the claim as clean. * * * If a written claim is 240
denied, the pharmacy benefit manager shall notify the pharmacy or 241
pharmacies no later than thirty-five (35) days * * * of receipt of 242
such claim * * *. The pharmacy benefit manager shall * * * notify 243
the pharmacist or pharmacy * * * of the reasons why the claim or 244
portion thereof is not clean and will not be paid and what 245
substantiating documentation and information is required to 246
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adjudicate the claim as clean. Any claim or portion thereof 247
resubmitted with the supporting documentation and information 248
requested by the pharmacy benefit manager shall be paid within 249
twenty (20) days after receipt. 250
( * * *3) If the board finds that any pharmacy benefit 251
manager, PSAO, agent or other party responsible for reimbursement 252
for prescription drugs and other products and supplies has not 253
paid ninety-five percent (95%) of clean claims as defined in 254
subsection (3) of this section received from all pharmacies in a 255
calendar quarter, * * * such pharmacy benefit manager, PSAO, agent 256
or other party responsible for reimbursement for prescription 257
drugs and other products and supplies shall be subject to an 258
administrative penalty of not more than Twenty-five Thousand 259
Dollars ($25,000.00) to be assessed by the * * * board * * *. 260
(a) Examinations to determine compliance with 261
this * * * section may be conducted by the board. The board may 262
contract with qualified impartial outside sources to assist in 263
examinations to determine compliance. * * * 264
(b) Nothing in the provisions of this section shall 265
require a pharmacy benefit manager to pay claims that are not 266
covered under the terms of a contract * * *, plan, policy of 267
accident and sickness insurance or prepaid coverage. 268
* * * 269
( * * *c) Any pharmacy benefit manager * * * may enter 270
into an express written agreement * * * with a pharmacy, or a PSAO 271
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on behalf of a pharmacy, that contains timely claim payment 272
provisions which differ from, but are at least as stringent as, 273
the provisions set forth under subsection (3) of this section, and 274
in such case, the provisions of the written agreement shall govern 275
the timely payment of claims by the pharmacy benefit manager or 276
PSAO to the pharmacy. If the express written agreement is silent 277
as to any interest penalty where claims are not paid in accordance 278
with the agreement, the interest penalty provision of 279
subsection * * * (5) of this section shall apply. 280
( * * *d) The * * * board * * * may adopt rules and 281
regulations necessary to ensure compliance with this subsection. 282
(4) If a clean claim is not paid or is denied without 283
providing to the pharmacy a valid and proper reason as to why the 284
claim is not clean by the end of the applicable time period 285
prescribed in this section, the pharmacy benefit manager must pay 286
the pharmacy (where the claim is owed to the pharmacy) or the 287
patient (where the claim is owed to a patient) interest on accrued 288
benefits at the rate of one and one-half percent (1-1/2%) per 289
month accruing from the day after payment was due on the amount of 290
the benefits that remain unpaid until the claim is finally settled 291
or adjudicated. Whenever interest due pursuant to this subsection 292
is less than One Dollar ($1.00), such amount shall be credited to 293
the account of the person or entity to whom such amount is owed. 294
(5) (a) * * * A network pharmacy or pharmacist may decline 295
to provide a brand name drug, * * * generic drug, biosimilar drug, 296
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or service, if the network pharmacy or pharmacist is paid less 297
than that network pharmacy's acquisition cost for the * * * 298
prescription. If the network pharmacy or pharmacist declines to 299
provide such drug or service, the pharmacy or pharmacist shall 300
provide the customer with adequate information as to where the 301
prescription for the drug or service may be filled. A pharmacy 302
benefit manager shall not require a pharmacy or pharmacist to 303
submit a claim for payment through a plan of the patient when the 304
patient requests to pay for the prescription drug with cash or an 305
alternative payment method. 306
(b) The * * * board * * * shall adopt rules and 307
regulations necessary to implement and ensure compliance with this 308
subsection, including, but not limited to, rules and regulations 309
that address access to pharmacy services in rural or underserved 310
areas and also in cases where a network pharmacy or pharmacist 311
declines to provide a drug or service under paragraph (a) of this 312
subsection. * * * 313
(6) A pharmacy benefit manager or PSAO shall not directly or 314
indirectly retroactively deny or reduce a claim or aggregate of 315
claims after the claim or aggregate of claims has been 316
adjudicated. 317
(7) A pharmacy benefit manager or PSAO shall not impose a 318
fee or otherwise adjust or lower the reimbursement of a claim at 319
the time the claim is adjudicated, or after the claim is 320
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adjudicated, that reduces the amount of the reimbursement for the 321
claim. 322
SECTION 4. Section 73-21-156, Mississippi Code of 1972, is 323
amended as follows: 324
73-21-156. * * * ( * * *1) A pharmacy benefit manager 325
shall: 326
(a) Provide a reasonable administrative appeal 327
procedure to allow pharmacies to challenge * * * reimbursements 328
made * * * for a specific drug or drugs as: 329
(i) Not meeting the requirements of this 330
section; * * * 331
(ii) Being below the pharmacy acquisition 332
cost * * *; or 333
(iii) Being below the reimbursement rate required 334
by subsection (1) of Section 73-21-155. 335
(b) The reasonable administrative appeal procedure 336
shall include the following: 337
(i) A * * * telephone number * * * and email 338
address * * * on the main page of the website of the pharmacy 339
benefit manager that provides direct access to the claim appeals 340
department; 341
(ii) The pharmacy benefit manager shall provide a 342
detailed written response within seven (7) days of receipt of an 343
email or telephone call from a pharmacist or pharmacy regarding an 344
issue with an administrative appeal; 345
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(iii) The website of the pharmacy benefit manager 346
shall include easily accessible administrative appeal instructions 347
and list any other required information to be submitted by 348
pharmacies for the purpose of submitting administrative appeals; 349
( * * *iv) The ability to submit * * * a single 350
administrative appeal or a claim appeal report for multiple claims 351
directly to the pharmacy benefit manager * * * or through a * * * 352
PSAO; and 353
( * * *v) A period of no less than thirty 354
(30) * * * days to file an administrative appeal. 355
(c) The pharmacy benefit manager shall respond to the 356
challenge under * * * this subsection * * * within thirty 357
(30) * * * days after receipt of the challenge. 358
(d) If a challenge is made under * * * this 359
subsection * * *, the pharmacy benefit manager shall within thirty 360
(30) * * * days after receipt of the challenge either: 361
(i) * * * Uphold the appeal * * * and: 362
1. * * * Adjust the reimbursement(s) paid to 363
the pharmacist or pharmacy to the greater of either the pharmacy 364
acquisition cost or the amount required pursuant to subsection (1) 365
of Section 73-21-155; 366
2. Permit the challenging pharmacy or 367
pharmacist to reverse and rebill the claim in question; and 368
* * * 369
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* * *3. Make the * * * adjustment for that 370
National Drug Code effective for * * * the pharmacy * * * that 371
filed the claim for a time period of no less than ninety (90) days 372
from the date the claim appeal was upheld; or 373
(ii) * * * Deny the appeal * * * and provide the 374
reason for the denial in writing to the challenging pharmacy or 375
pharmacist * * *. 376
(e) The board may adopt rules and regulations necessary 377
to ensure compliance with this subsection. 378
(2) A pharmacy benefit manager shall not deny an appeal 379
submitted pursuant to this section based upon an existing 380
contracted rate with the pharmacy. 381
(3) A pharmacy or pharmacist that belongs to a PSAO shall be 382
provided a true and correct copy of any contract and contract 383
amendment that the PSAO enters into with a pharmacy benefit 384
manager or third-party payer on the pharmacy's or pharmacist's 385
behalf. 386
( * * *4) * * * A pharmacy benefit manager or PSAO shall not 387
reimburse a pharmacy or pharmacist in the state an amount less 388
than the amount that the pharmacy benefit manager reimburses a 389
pharmacy benefit manager affiliate for providing the same * * * 390
drug, and the amount reimbursed shall not be less than the amount 391
prescribed pursuant to subsection (1) of Section 73-21-155. * * * 392
The reimbursement amount for a drug shall be calculated on a per 393
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unit basis based on the same brand and generic product identifier 394
or brand and generic code number. 395
(5) The pharmacy benefit manager or PSAO shall not require a 396
pharmacy to collect additional monies following a successful 397
below-cost reimbursement appeal from any person or entity other 398
than the pharmacy benefit manager who adjudicated the drug claim, 399
including the patient or plan sponsor. 400
SECTION 5. Section 73-21-157, Mississippi Code of 1972, is 401
amended as follows: 402
73-21-157. (1) Before beginning to do business as a 403
pharmacy benefit manager or PSAO, a pharmacy benefit manager or 404
PSAO shall obtain a license to do business from the board. To 405
obtain a license, the applicant shall submit an application to the 406
board on a form to be prescribed by the board. This license shall 407
be renewed annually. 408
(2) When applying for a license or renewal of a license, 409
each pharmacy benefit manager * * * shall file * * * with the 410
board * * *: 411
(a) A copy of a certified audit report, if the pharmacy 412
benefit manager has been audited by a certified public accountant 413
within the last twenty-four (24) months; or 414
( * * *b) If the pharmacy benefit manager has not been 415
audited in the last twenty-four (24) months, a financial statement 416
of the organization, including its balance sheet and income 417
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statement for the preceding year which shall be verified by at 418
least two (2) principal officers; and 419
( * * *c) Any other information relating to the 420
operations of the pharmacy benefit manager or PSAO required by the 421
board * * *. 422
( * * *3) (a) Any information required to be submitted to 423
the board pursuant to licensure application that is considered 424
proprietary by a pharmacy benefit manager or PSAO shall be marked 425
as confidential when submitted to the board. All such information 426
shall not be subject to the provisions of the federal Freedom of 427
Information Act or the Mississippi Public Records Act and shall 428
not be released by the board unless subject to an order from a 429
court of competent jurisdiction. The board shall destroy or 430
delete or cause to be destroyed or deleted all such information 431
thirty (30) days after the board determines that the information 432
is no longer necessary or useful. 433
(b) Any person who knowingly releases, causes to be 434
released or assists in the release of any such information shall 435
be subject to a monetary penalty imposed by the board in an amount 436
not exceeding Fifty Thousand Dollars ($50,000.00) per violation. 437
When the board is considering the imposition of any penalty under 438
this paragraph (b), it shall follow the same policies and 439
procedures provided for the imposition of other sanctions in the 440
Pharmacy Practice Act. Any penalty collected under this paragraph 441
(b) shall be deposited into the special fund of the board and used 442
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to support the operations of the board relating to the regulation 443
of pharmacy benefit managers. 444
(c) All employees of the board who have access to the 445
information described in paragraph (a) of this subsection shall be 446
fingerprinted, and the board shall submit a set of fingerprints 447
for each employee to the Department of Public Safety for the 448
purpose of conducting a criminal history records check. If no 449
disqualifying record is identified at the state level, the 450
Department of Public Safety shall forward the fingerprints to the 451
Federal Bureau of Investigation for a national criminal history 452
records check. 453
( * * *4) * * * The board may waive the requirements for 454
filing financial information for the pharmacy benefit manager if 455
an affiliate of the pharmacy benefit manager is already required 456
to file such information under current law with the Commissioner 457
of Insurance and allow the pharmacy benefit manager to file a copy 458
of documents containing such information with the board in lieu of 459
the statement required by this section. 460
( * * *5) The expense of administering this section shall be 461
assessed annually by the board against all pharmacy benefit 462
managers and PSAOs operating in this state. 463
(6) A pharmacy benefit manager, PSAO or third-party 464
payor * * * shall not require pharmacy accreditation standards 465
or * * * certification requirements inconsistent with, more 466
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stringent than, or in addition to federal and state requirements 467
for licensure as a pharmacy in this state. 468
SECTION 6. The following shall be codified as Section 469
73-21-158, Mississippi Code of 1972: 470
73-21-158. (1) A pharmacy benefit manager shall be 471
prohibited from engaging in spread pricing. Separately identified 472
administrative fees or costs are exempt from this requirement, if 473
mutually agreed upon in writing by the payor and pharmacy benefit 474
manager. 475
(2) A pharmacy benefit manager or third-party payer shall 476
not charge or cause a patient to pay an amount that exceeds the 477
total amount retained by the pharmacy. 478
(3) A pharmacy benefit manager shall pass on to the plan 479
sponsor one hundred percent (100%) of all rebates and other 480
payments that the pharmacy benefit manager received from 481
pharmaceutical manufacturers or rebate aggregators in connection 482
with claims if administered on behalf of the plan sponsor. 483
(4) A pharmacy benefit manager or PSAO shall not charge a 484
pharmacist or pharmacy a fee related to the adjudication of a 485
claim including without limitation a fee for: 486
(a) The submission or processing of a claim; 487
(b) The adjudication of a claim; 488
(c) Enrollment or participation in a pharmacy network; 489
or 490
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(d) The development or management of claims processing 491
services or claims payment services related to participation in a 492
pharmacy network. 493
(5) A pharmacy benefit manager or PSAO shall not charge a 494
pharmacist or pharmacy a fee related to participation in a 495
pharmacy network including but not limited to the following: 496
(a) An application fee, 497
(b) An enrollment or participation fee, 498
(c) A credentialing or re-credentialing fee, 499
(d) A change of ownership fee, or 500
(e) A fee for the development or management of claims 501
processing services or claims payment services. 502
SECTION 7. Section 73-21-161, Mississippi Code of 1972, is 503
amended as follows: 504
73-21-161. (1) As used in this section, the term 505
" * * *steering" means: 506
(a) Directing, ordering * * *, or requiring a patient 507
to use a specific affiliate pharmacy * * * or pharmacies for the 508
purpose of filling a prescription or receiving services or other 509
care from a pharmacist; 510
(b) Offering or implementing plan designs that 511
require * * * a patient to utilize an affiliate pharmacy or 512
pharmacies, or that increase costs to a patient, including, but 513
not limited to, requiring a patient to pay the full cost for a 514
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prescription drug when such patient chooses not to use a pharmacy 515
benefit manager affiliate pharmacy; * * * 516
(c) * * * Advertising, marketing, or * * * promoting an 517
affiliate * * * pharmacy or pharmacies over another in-network 518
pharmacy, but does not include a pharmacy's inclusion by a 519
pharmacy benefit manager or pharmacy benefit manager affiliate in 520
communications to patients, including patient and prospective 521
patient specific communications, regarding network pharmacies and 522
prices, provided that the pharmacy benefit manager or a pharmacy 523
benefit manager affiliate includes information regarding eligible 524
nonaffiliate pharmacies in those communications and the 525
information provided is accurate; 526
(d) Creating any network or engaging in any practice, 527
including accreditation or credentialing standards, day supply 528
requirements or delivery methods requirements, that exclude an 529
in-network pharmacy or restrict an in-network pharmacy from 530
filling a prescription for a prescription drug; or 531
(e) Directly or indirectly engaging in any practice 532
that attempts to influence or induce a pharmaceutical manufacturer 533
to limit the distribution of a prescription drug to a small number 534
of pharmacies or certain types of pharmacies, or to restrict 535
distribution of such drug to non-affiliate pharmacies. 536
* * * 537
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(2) A pharmacy, pharmacy benefit manager, or pharmacy 538
benefit manager affiliate licensed or operating in Mississippi 539
shall be prohibited from: 540
(a) * * * Steering; 541
(b) Transferring or sharing records relative to 542
prescription information containing patient identifiable and 543
prescriber identifiable data to or from a pharmacy benefit manager 544
affiliate for any commercial purpose; however, nothing in this 545
section shall be construed to prohibit the exchange of 546
prescription information between a pharmacy and its affiliate for 547
the limited purposes of pharmacy reimbursement; formulary 548
compliance; pharmacy care; public health activities otherwise 549
authorized by law; or utilization review by a health care 550
provider; * * * 551
(c) Presenting a claim for payment to any individual, 552
third-party payor, affiliate, or other entity for a prescription 553
drug or service furnished * * * by steering from * * * a pharmacy 554
benefit manager or pharmacy benefit manager affiliate * * *; or 555
(d) Interfering with the patient's right to choose the 556
patient's pharmacy or provider of choice, including inducement, 557
required referrals or offering financial or other incentives or 558
measures that would constitute a violation of Section 83-9-6. 559
(3) This section shall not be construed to prohibit a 560
pharmacy from entering into an agreement with a pharmacy benefit 561
manager or pharmacy benefit manager affiliate to provide pharmacy 562
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care to patients, provided that neither the pharmacy * * * nor the 563
pharmacy benefit manager or pharmacy benefit manager affiliate 564
violate subsection (2) of this section and the pharmacy provides 565
the disclosures required in subsection (1) of this section. 566
* * * 567
( * * *4) In addition to any other remedy provided by law, a 568
violation of this section by a pharmacy, pharmacy benefit manager 569
or pharmacy benefit manager affiliate shall be grounds for 570
disciplinary action by the board under its authority granted in 571
this chapter. 572
( * * *5) A pharmacist who fills a prescription that 573
violates subsection (2) of this section shall not be liable under 574
this section. 575
(6) This section shall not apply to facilities licensed to 576
fill prescriptions solely for employees of a plan sponsor or 577
employer. 578
SECTION 8. The following shall be codified as Section 579
73-21-162, Mississippi Code of 1972: 580
73-21-162. (1) Retaliation is prohibited. 581
(a) A pharmacy benefit manager, pharmacy benefit 582
manager affiliate or PSAO shall not retaliate against a pharmacist 583
or pharmacy based on the pharmacist's or pharmacy's exercise of 584
any right or remedy under this chapter. Retaliation prohibited by 585
this section includes, but is not limited to: 586
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(i) Terminating or refusing to renew a contract 587
with the pharmacist or pharmacy; 588
(ii) Subjecting the pharmacist or pharmacy to an 589
increased frequency of audits, number of claims audited or amount 590
of monies for claims audited; or 591
(iii) Failing to promptly pay the pharmacist or 592
pharmacy any money owed by the pharmacy benefit manager to the 593
pharmacist or pharmacy. 594
(b) For the purposes of this section, a pharmacy 595
benefit manager, pharmacy benefit manager affiliate or PSAO is not 596
considered to have retaliated against a pharmacy if the pharmacy 597
benefit manager: 598
(i) Takes an action in response to a credible 599
allegation of fraud against the pharmacist or pharmacy; and 600
(ii) Provides reasonable notice and a reasonable 601
opportunity to respond to the pharmacist or pharmacy of the 602
allegation of fraud and the basis of the allegation before 603
initiating an action. 604
(2) A pharmacy benefit manager, pharmacy benefit manager 605
affiliate or PSAO shall not penalize or retaliate against a 606
pharmacist, pharmacy or pharmacy employee for exercising any 607
rights under this chapter, initiating any judicial or regulatory 608
actions or discussing or disclosing information pertaining to an 609
agreement with a pharmacy benefit manager or a pharmacy benefit 610
manager affiliate when testifying or otherwise appearing before 611
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any governmental agency, legislative member or body or any 612
judicial authority. 613
SECTION 9. Section 73-21-163, Mississippi Code of 1972, is 614
amended as follows: 615
73-21-163. (1) Whenever the board has reason to believe 616
that a pharmacy benefit manager * * *, pharmacy benefit manager 617
affiliate or PSAO is using, has used, or is about to use any 618
method, act or practice prohibited in * * * this act and that 619
proceedings would be in the public interest, it may bring an 620
action in the name of the board against the pharmacy benefit 621
manager * * *, pharmacy benefit manager affiliate or PSAO to 622
restrain by temporary or permanent injunction the use of such 623
method, act or practice. The action shall be brought in the 624
Chancery Court of the First Judicial District of Hinds County, 625
Mississippi. The court is authorized to issue temporary or 626
permanent injunctions to restrain and prevent violations of * * * 627
this act and such injunctions shall be issued without bond. 628
(2) The board may impose a monetary penalty on a pharmacy 629
benefit manager, or a pharmacy benefit manager affiliate or a PSAO 630
for noncompliance with the provisions of * * * this act, in 631
amounts of not less than One Thousand Dollars ($1,000.00) per 632
violation and not more than Twenty-five Thousand Dollars 633
($25,000.00) per violation. Each day a violation continues for 634
the same brand or generic product identifier or brand or generic 635
code number is a separate violation. Each day that a pharmacy 636
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benefit manager or PSAO does business in this state without a 637
license is deemed a separate violation. The board shall prepare a 638
record entered upon its minutes that states the basic facts upon 639
which the monetary penalty was imposed and reduce its decision to 640
writing. Each instance that a pharmacy benefit manager or PSAO 641
fails to comply with the written order of the board shall be a 642
separate violation of this act. Any penalty collected under this 643
subsection (2) shall be deposited into the special fund of the 644
board. 645
(3) For the purposes of conducting investigations, the 646
board, through its executive director, may conduct audits and 647
examinations of a pharmacy benefit manager or PSAO and may also 648
issue subpoenas to any individual, pharmacy, pharmacy benefit 649
manager, PSAO or any other entity having documents or records that 650
it deems relevant to the investigation. 651
( * * *4) The board may assess a monetary penalty for those 652
reasonable costs that are expended by the board in the 653
investigation and conduct of a proceeding, including the cost of 654
process service, court reporters, expert witnesses and 655
investigators, if the board imposes a monetary penalty under 656
subsection (2) of this section. * * * 657
(5) Monetary * * * penalties and costs assessed and levied 658
under this section shall be paid to the board by the licensee, 659
registrant or permit holder upon the expiration of the period 660
allowed for appeal of those penalties under Section 73-21-101, or 661
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may be paid sooner if the licensee, registrant or permit holder 662
elects. Any penalty collected by the board under this subsection 663
( * * *5) shall be deposited into the special fund of the board. 664
( * * *6) When payment of a monetary penalty assessed and 665
levied by the board against a licensee, registrant or permit 666
holder in accordance with this section is not paid by the 667
licensee, registrant or permit holder when due under this section, 668
the board shall have the power to institute and maintain 669
proceedings in its name for enforcement of payment in the chancery 670
court of the county and judicial district of residence of the 671
licensee, registrant or permit holder, or if the licensee, 672
registrant or permit holder is a nonresident of the State of 673
Mississippi, in the Chancery Court of the First Judicial District 674
of Hinds County, Mississippi. When those proceedings are 675
instituted, the board shall certify the record of its proceedings, 676
together with all documents and evidence, to the chancery court 677
and the matter shall be heard in due course by the court, which 678
shall review the record and make its determination thereon in 679
accordance with the provisions of Section 73-21-101. The hearing 680
on the matter may, in the discretion of the chancellor, be tried 681
in vacation. 682
(7) (a) The board may conduct audits to ensure compliance 683
with the provisions of this act. In conducting audits, the board 684
is empowered to request production of documents pertaining to 685
compliance with the provisions of this act, and documents so 686
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requested shall be produced within seven (7) days of the request 687
unless extended by the board or its duly authorized staff. 688
(b) If, after the conclusion of the audit, the pharmacy 689
benefit manager or PSAO was found to be in compliance with all of 690
the requirements of this act, then the board shall pay the costs 691
of the audit. However, the pharmacy benefit manager or PSAO being 692
audited shall pay all costs of such audit if such audit reveals 693
any noncompliance with this act. The cost of the audit 694
examination shall be deposited into the special fund and shall be 695
used by the board, upon appropriation of the Legislature, to 696
support the operations of the board relating to the regulation of 697
pharmacy benefit managers. 698
(c) The board is authorized to hire independent 699
consultants to conduct audits of a pharmacy benefit manager or 700
PSAO and expend funds collected under this section to pay the cost 701
of performing audit services. 702
( * * *8) The board shall develop and implement a uniform 703
penalty policy that sets the minimum and maximum penalty for any 704
given violation of * * * this act. The board shall adhere to its 705
uniform penalty policy except in those cases where the board 706
specifically finds, by majority vote, that a penalty in excess of, 707
or less than, the uniform penalty is appropriate. That vote shall 708
be reflected in the minutes of the board and shall not be imposed 709
unless it appears as having been adopted by the board. 710
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SECTION 10. The following shall be codified as Section 711
73-21-165, Mississippi Code of 1972: 712
73-21-165. (1) A pharmacy benefit manager shall report to 713
the board annually, or more often as the board deems necessary, 714
for each plan sponsor the following information: 715
(a) The aggregate amount of rebates and other payments 716
that the pharmacy benefit manager received from pharmaceutical 717
manufacturers or rebate aggregators in connection with claims if 718
administered on behalf of the plan sponsor; 719
(b) The aggregate amount of rebates distributed to each 720
plan sponsor contracted with the pharmacy benefit manager; 721
(c) The aggregate amount of rebates passed on to the 722
enrollees of each plan sponsor at the point of sale that reduced 723
the enrollees' applicable deductible, copayment, coinsurance or 724
other cost-sharing amount; 725
(d) The individual and aggregate amount paid by the 726
plan sponsor to the pharmacy benefit manager for pharmacist 727
services itemized by pharmacy, by product, and by good and 728
services; 729
(e) The individual and aggregate amount a pharmacy 730
benefit manager paid for pharmacist services itemized by pharmacy, 731
product, and by goods and services; and 732
(f) If at any time during the reporting period the 733
pharmacy benefit manager moved or reassigned a prescription drug 734
to a formulary tier that has a higher cost, higher copayment, 735
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higher coinsurance, higher deductible to a consumer or lower 736
reimbursement to a pharmacy, an explanation of the reason why the 737
drug was moved or reassigned, including whether the move or 738
reassignment was determined or requested by a pharmaceutical 739
manufacturer or other entity. 740
(2) (a) A pharmacy benefit manager shall annually report in 741
the aggregate to the board and to a plan sponsor the difference 742
between the amount the pharmacy benefit manager reimbursed a 743
pharmacy and the amount the pharmacy benefit manager charged a 744
plan sponsor. 745
(b) A pharmacy benefit manager shall report to each 746
plan sponsor the aggregate amount of all rebates and other 747
payments that the pharmacy benefit manager received from 748
pharmaceutical manufacturers or rebate aggregators in connection 749
with claims if administered on behalf of the plan sponsor. 750
(3) Any pharmacy benefit manager that owns, controls, or is 751
affiliated with a pharmacy shall also report annually to the 752
board, any difference in reimbursement rates or practices, direct 753
and indirect renumeration fees or other price concessions, and any 754
reduction in reimbursements between a pharmacy that is owned, 755
controlled or affiliated with the pharmacy benefit manager and 756
another pharmacy. 757
SECTION 11. The following shall be codified as Section 758
73-21-167, Mississippi Code of 1972: 759
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73-21-167. (1) There is created the Mississippi Specialty 760
Drug Committee that shall develop a list of prescription drugs 761
that meet the criteria for specialty drug designation to assist 762
with patient access, transparency and responsible cost management. 763
The committee shall meet to review and update the list based on 764
market trends, clinical data and stakeholder input. 765
(2) The committee shall be composed of the following 766
members: 767
(a) One (1) licensed pharmacist from each of the 768
following organizations: the Mississippi Independent Pharmacies 769
Association, the Mississippi Pharmacy Association, the Mississippi 770
Society of Health-System Pharmacists and the Magnolia State 771
Pharmaceutical Society; 772
(b) Two (2) licensed physicians appointed by the 773
Mississippi State Medical Association; 774
(c) A representative from the Mississippi Association 775
of Health Plans; 776
(d) A representative from the Pharmaceutical Care 777
Management Association; 778
(e) A representative from the Mississippi Business 779
Alliance; 780
(f) The executive director of the Mississippi Board of 781
Pharmacy or his or her designee, to serve as nonvoting temporary 782
chair for the initial organizational meeting of the committee; 783
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(g) A representative from the Office of Insurance of 784
the Department of Finance and Administration; and 785
(h) The Chairs or their designees from the Senate and 786
House of Representative Drug Policy Committees, who will serve as 787
nonvoting members. 788
(3) (a) Appointments to the committee shall be made and 789
provided to the executive director of board within thirty (30) 790
days after the effective date of this act. Within fifteen (15) 791
days thereafter on a day to be designated by the executive 792
director of the board, the committee shall meet and organize by 793
selecting from its membership a chair and a vice chair. The vice 794
chair shall also serve as secretary and shall be responsible for 795
keeping all records for the committee. A majority of the members 796
of the committee shall constitute a quorum. In the selection of 797
its officers and the adoption of the specialty drug list, rules, 798
resolutions and reports, an affirmative vote of the majority of 799
the voting committee members present shall be required. All 800
members shall be notified in writing of all meetings, and those 801
notices shall be mailed at least fifteen (15) days before the date 802
on which a meeting is to be held. 803
(b) The committee shall meet at least once quarterly, 804
and shall create the initial list of specialty drugs not later 805
than December 1, 2026. The initial and updated lists of specialty 806
drugs shall be posted on the official website of the state 807
agencies and boards serving on the committee. 808
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(4) The Mississippi Board of Pharmacy shall provide the 809
office space, staff and other support necessary for the committee 810
to perform its duties. 811
(5) Pharmacy benefit managers licensed with the board shall 812
adhere to the established list of specialty drugs when contracting 813
with a pharmacy and establishing payment levels and adjudicating 814
drug claims or any portion of the transaction. Noncompliance with 815
this subsection shall be deemed a violation of this act. 816
SECTION 12. The following shall be codified as Section 817
73-21-211, Mississippi Code of 1972: 818
73-21-211. Sections 73-21-211 through Section 73-21-217 819
shall be known as the "Pharmacy Fair Competition Act." 820
SECTION 13. The following shall be codified as Section 821
73-21-213, Mississippi Code of 1972: 822
73-21-213. The Legislature finds and declares that the 823
distribution and retail sales of pharmaceutical drugs in the State 824
of Mississippi vitally affect the general economy of the state and 825
the public interest and the public welfare. The Legislature 826
further finds and declares that it is necessary, in the exercise 827
of its police power, to regulate, register and/or license drug 828
manufacturers, wholesale distributors, pharmacy service 829
administration organizations and retail pharmacies doing business 830
in the State of Mississippi in order to: 831
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(a) Prevent frauds, unfair practices, discrimination, 832
impositions and other abuses upon the citizens of the State of 833
Mississippi; 834
(b) Avoid undue control of the retail pharmacy by drug 835
manufacturing and distributing organizations, pharmacy service 836
administration organizations or pharmacy benefit managers; 837
(c) Foster and keep alive vigorous and healthy 838
competition; 839
(d) Prevent the creation or perpetuation of monopolies; 840
(e) Prevent the practice of requiring the unnecessary 841
requirements on retail pharmacies that add to the costs and timely 842
administration of healthcare to Mississippi citizens; 843
(f) Prevent false and misleading advertising; and 844
(g) Promote the public safety and welfare. 845
SECTION 14. The following shall be codified as Section 846
73-21-215, Mississippi Code of 1972: 847
73-21-215. (1) As used in this section: 848
(a) "Board" means the Mississippi Board of Pharmacy. 849
(b) "Permit" means a permit issued under Section 850
73-21-105 or Section 73-21-106. 851
(c) "Pharmacy benefit manager" means that term defined 852
in Section 73-21-153. 853
(d) "Plan sponsor" means that term as defined in 854
Section 73-21-153. 855
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(2) (a) A pharmacy benefit manager shall not acquire direct 856
or indirect interest in, or otherwise hold, directly or 857
indirectly, a pharmacy permit for the retail sale of drugs or 858
medicines in this state. 859
(b) On and after the effective date of this act, the 860
Mississippi Board of Pharmacy shall either revoke or not renew a 861
pharmacy permit of an entity that violates this section. 862
(3) (a) The board may issue a limited use permit upon a 863
determination that certain rare, orphan, or limited distribution 864
drugs are otherwise unavailable in the market to a patient or a 865
pharmacy that would otherwise be prohibited under this section. 866
(b) The board may assess the need for rare, orphan or 867
limited distribution drugs for a limited use permit for certain 868
rare, orphan or limited distribution drugs under subsection (3)(a) 869
of this section before revocation or renewal of an existing retail 870
permit for a pharmacy. If the assessment made by the board under 871
this paragraph determines that a rare, orphan or limited 872
distribution drug is otherwise unavailable in the market to a 873
patient or pharmacy that would otherwise be prohibited in this 874
section, the board shall convert the retail permit for the 875
prohibited pharmacy to a limited use permit for that pharmacy for 876
a period of no less than ninety (90) days. 877
(c) A limited use permit shall not be issued by the 878
board if a determination is made that the unavailability of the 879
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rare, orphan or limited distribution drug has been created by the 880
pharmacy benefit manager or plan sponsor. 881
(4) The process for requesting a limited use permit shall be 882
as follows: 883
(a) A request by a permitted pharmacy for a limited use 884
permit for a rare, orphan or limited distribution drug unavailable 885
in the market shall be made in writing to the board; 886
(b) The written request shall provide the name and 887
description of the drug, a detailed description of the patient's 888
need for the drug, and an explanation as to why the rare, orphan 889
or limited distribution drug is unavailable in the market; 890
(c) The executive director for the board shall review 891
the written request and make a determination on whether to issue 892
the limited use permit within twenty (20) days from the date of 893
the written request; 894
(d) If the requestor is aggrieved by the decision of 895
the executive director, a petition may be made to the board, in 896
writing, and an administrative hearing on the matter shall be held 897
before the board within twenty (20) days of receipt of the 898
petition; 899
(e) The board shall, within thirty (30) days after 900
conclusion of the hearing, reduce its decision to writing and 901
forward an attested true copy thereof to the last-known business 902
address of such pharmacy permit by way of United States 903
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first-class, certified mail, postage prepaid and by email to the 904
address provided to the board in its licensing system; and 905
(f) If the requestor asserts in the written request 906
that there is a need for an emergency determination due to patient 907
need, a permitted pharmacy may dispense a one-time emergency 908
dispensing of the rare, orphan or limited distribution drug for up 909
to twenty (20) days from the date of the written request pending a 910
decision by the executive director for the board. The written 911
request shall include information describing that there is need 912
for an emergency determination due to patient need and provide a 913
detailed reason for the emergency. 914
(5) The board may extend the use of a retail permit or issue 915
a renewal of a retail permit for a pharmacy that offers same-day 916
patient access for pharmacist services, a prescription for a 917
controlled substance, mental health services, or other critical 918
patient healthcare services for a period of time as determined by 919
order of the board if there is a pending sale of the pharmacy to 920
an eligible buyer. 921
(6) This section does not apply to a pharmacy employer and a 922
pharmacy that exclusively services the employees and dependents of 923
the pharmacy employer while utilizing the affiliated pharmacy 924
benefit manager in this state. 925
SECTION 15. The following shall be codified as Section 926
73-21-217, Mississippi Code of 1972: 927
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73-21-217. (1) The board shall conduct an initial 928
assessment of each active retail pharmacy permit issued as of July 929
1, 2026, and shall send written notice at least ninety (90) days 930
before January 1, 2027, to each pharmacy permit holder that the 931
board reasonably believes will violate this act. As used in this 932
subsection (1), "written notice" means actual notice to the 933
pharmacy permit holder via mail or email, including an email 934
through its licensing system. 935
(2) The written notice required under subsection (1) of this 936
section shall include a list of each pharmacy benefit manager that 937
holds a direct or indirect interest in, or otherwise holds, 938
directly or indirectly, a permit under Section 73-21-105 or 939
Section 73-21-106 for the retail sale of drugs or medicines in 940
this state held by the pharmacy permit holder. 941
(3) (a) A pharmacy permit holder with written notice from 942
the board under subsection (1) of this section shall provide its 943
own written notice at least sixty (60) days before January 1, 944
2027, to each patient and each patient's prescribing healthcare 945
provider that has used the pharmacy within the previous twelve 946
(12) months that the pharmacy can no longer dispense retail drugs 947
to the patient on or after January 1, 2027. The written notice 948
that a pharmacy permit holder with written notice from the board 949
under subsection (1) of this section must provide to each patient 950
and each patient's prescribing healthcare provider that has used 951
the pharmacy within the previous twelve (12) months shall be 952
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actual notice to the patient via mail or email or through the 953
pharmacy's patient portal. 954
(b) A pharmacy that is determined by the board to be in 955
violation of this section after the date set forth in subsection 956
(1) is not exempt from this act. Within sixty (60) days of a 957
written notice from the board, such pharmacies shall provide 958
written notice to each patient and each patient's prescribing 959
healthcare provider that has used the pharmacy within the previous 960
twelve (12) months that the pharmacy can no longer dispense retail 961
drugs to the patient after thirty (30) days from the date of the 962
pharmacy's notice. 963
(4) Each licensed pharmacy benefit manager licensed as of 964
July 1, 2026, shall send a written list to the board, no later 965
than September 1, 2026, of any retail pharmacy that the pharmacy 966
benefit manager holds a direct or indirect interest in, or 967
otherwise holds, directly or indirectly, and is permitted by the 968
board. 969
(5) Each permitted retail pharmacy permitted as of July 1, 970
2026, shall send a written list to the board, no later than 971
September 1, 2026, of any pharmacy benefit manager that holds a 972
direct or indirect interest in, or otherwise holds, directly or 973
indirectly, the permitted retail pharmacy. 974
SECTION 16. Section 25-15-301, Mississippi Code of 1972, is 975
amended as follows: 976
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25-15-301. (1) The board may contract the administration 977
and service of the self-insured program to a third party. 978
Whenever the board chooses to contract with an administrator for 979
the insurance plan established by Section 25-15-3 et seq. or 980
components thereof, it shall comply with the procedures set forth 981
in this section: 982
(a) If the board determines that it should contract out 983
the administration of the plan to an administrator, it shall cause 984
to be prepared a request for proposals. This request for 985
proposals shall be prepared for distribution to any interested 986
party. Notice of the board's intention to seek proposals shall be 987
published in a newspaper of general circulation at least one (1) 988
time per week for three (3) weeks before closing the period for 989
interested parties to respond. Additional forms of notice may 990
also be used. The newspaper notice shall inform the interested 991
parties of the service to be contracted, existence of a request 992
for proposals, how it can be obtained, when a proposal must be 993
submitted, and to whom the proposal must be submitted. All 994
requests for proposals shall describe clearly what service is to 995
be contracted, and shall fully explain the criteria upon which an 996
evaluation of proposals shall be based. The criteria to be used 997
for evaluations shall, at minimum, include: 998
(i) The administrator's proven ability to 999
handle * * * group accident and health insurance plans comparable 1000
to the plan; 1001
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(ii) The efficiency of the claims-paying 1002
procedures; and 1003
(iii) * * * The total charges for administering 1004
the plan. 1005
(b) All proposals submitted by interested parties shall 1006
be evaluated by an internal review committee which shall apply the 1007
same criteria to all proposals when conducting an evaluation. The 1008
committee shall consist of at least three (3) members of the 1009
board. When the proposal under evaluation is for pharmacy 1010
benefits or the management thereof, the executive director of the 1011
Mississippi Board of Pharmacy, or his or her designee, shall be 1012
one (1) of the members of the evaluation committee. The results 1013
and recommendations of the evaluation shall be presented to the 1014
board for review. All evaluations presented to the board shall be 1015
retained by the board for at least three (3) years. The board may 1016
accept or reject any recommendation of the review committee, or it 1017
may conduct further inquiry into the proposals. Any further 1018
inquiry shall be clearly documented and all methods and 1019
recommendations shall be retained by the board and shall spread 1020
upon its minutes its choice of administrator and its reasons for 1021
making the choice. 1022
(c) (i) The board shall be responsible for preparing a 1023
contract that shall be in accordance with all provisions of this 1024
section and all other provisions of law. The contract shall also 1025
include a requirement that the contractor shall consent to an 1026
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evaluation of his performance. Such evaluation shall occur after 1027
the first six (6) months of the contract, and the contractor's 1028
performance shall be reviewed at times the board determines to be 1029
necessary. The contract shall clearly describe the standards upon 1030
which the contractor shall be evaluated. Evaluations shall 1031
include, but not be limited to, efficiency in claims processing, 1032
including the processing of pending claims. 1033
(ii) The PEER Committee, at the request of the 1034
House or Senate Appropriations Committee or the House or Senate 1035
Insurance Committee and with funds specifically appropriated by 1036
the Legislature for such purpose, shall contract with an 1037
accounting firm or with other professionals to conduct a 1038
compliance audit of any administrator responsible for 1039
administering the insurance plan established by Section 25-15-3 et 1040
seq. or components thereof. Such audit shall review the 1041
administrator's compliance with the performance standards required 1042
for inclusion in the administrator's contract. Such audit shall 1043
be delivered to the Legislature no later than January 1. 1044
(iii) An audit for pharmacy benefits or the 1045
management thereof may also be conducted by the Mississippi Board 1046
of Pharmacy, under the provisions of Chapter 21, Title 73, 1047
Mississippi Code 1972. Any audits conducted by the Mississippi 1048
Board of Pharmacy shall be provided to the board and the PEER 1049
Committee within fifteen (15) days of final adoption of the 1050
results by the Board of Pharmacy. 1051
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(2) Contracts for the administration of the insurance plan 1052
established in Section 25-15-3 et seq. or components thereof shall 1053
commence at the beginning of the calendar year and shall end on 1054
the last day of a calendar year. This shall not apply to 1055
contracts provided for in subsection (3) of this section. 1056
(3) If the board determines that it is necessary to not 1057
renew the contract of an administrator, or finds it necessary to 1058
terminate a contract with or without cause as provided for in the 1059
contract of the administrator, the board is authorized to select 1060
an administrator without complying with the bid requirements in 1061
subsections (1) and (2) of this section. Such contracts shall be 1062
for the balance of the calendar year in which the nonrenewal or 1063
termination occurred, and may be for an additional calendar year 1064
if the board determines that the best interests of the plan 1065
members are served by such. Any contract negotiated on an interim 1066
basis shall include a detailed transition plan which shall ensure 1067
the orderly transfer of responsibilities between administrators 1068
and shall include, but not be limited to, provisions regarding the 1069
transfer of records, files and tapes. 1070
(4) Except for contracts executed under the authority of 1071
subsection (3) of this section, the board shall select 1072
administrators at least six (6) months before the expiration of 1073
the current administrator's contract. The period between the 1074
selection of the new administrator and the effective date of the 1075
new contract shall be known as the transition period. Whenever 1076
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the newly selected administrator is an entity different from the 1077
entity performing the administrator's function, it shall be the 1078
duty of the board to prepare a detailed transition plan which 1079
shall insure the orderly transfer of responsibilities between 1080
administrators. This plan shall be effective during the 1081
transition period, and shall include, but not be limited to, 1082
provisions regarding the transfer of records, files and tapes. 1083
Further, the plan shall detail the steps necessary to transfer 1084
records and responsibilities and set deadlines for when such steps 1085
should be completed. The board shall include in all requests for 1086
proposals, contracts with administrators, and all other contracts, 1087
provisions requiring the cooperation of administrators and 1088
contractors in any future transition of responsibilities, and 1089
their cooperation with the board and other contractors with 1090
respect to ongoing coordination and delivery of health plan 1091
services. The board shall furnish the Legislature, Governor and 1092
advisory council with copies of all transition plans and keep them 1093
informed of progress on such plans. 1094
(5) No brokerage fees shall be paid for the securing or 1095
executing of any contracts pertaining to the insurance plan 1096
established by Section 25-15-3 et seq. or components thereof, 1097
whether fully insured or self-insured. 1098
(6) (a) Any corporation, association, company, entity or 1099
individual that contracts with the board for the administration or 1100
service of the self-insured plan shall remit one hundred percent 1101
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(100%) of all savings or discounts resulting from any contract to 1102
the board or participant, or both. Any corporation, association, 1103
company, entity or individual that contracts with the board for 1104
the administration or service of the self-insured plan shall 1105
allow, upon notice by the board, the board or its designee to 1106
audit records of the corporation, association, company, entity or 1107
individual relative to the corporation, association, company or 1108
individual's performance under any contract with the board. The 1109
information maintained by any corporation, association, company, 1110
entity or individual, relating to such contracts, shall be 1111
available for inspection upon request by the board and such 1112
information shall be compiled in a manner that will provide a 1113
clear audit trail. 1114
(b) Any corporation, association, company, entity or 1115
individual that contracts with the board for the administration or 1116
service of the pharmacy benefits or management thereof of the 1117
self-insured plan shall also comply with the provisions of Chapter 1118
21, Title 73, Mississippi Code 1972. If there is a conflict in 1119
the application or interpretation of this section and those 1120
provisions, then the provision of those statutes shall govern. 1121
SECTION 17. Section 25-15-303, Mississippi Code of 1972, is 1122
amended as follows: 1123
25-15-303. (1) There is created the State and School 1124
Employees Health Insurance Management Board, which shall 1125
administer the State and School Employees Life and Health 1126
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Insurance Plan provided for under Section 25-15-3 et seq. The 1127
State and School Employees Health Insurance Management Board, 1128
hereafter referred to as the "board," shall also be responsible 1129
for administering all procedures for selecting third-party 1130
administrators provided for in Section 25-15-301. 1131
(2) The board shall consist of the following: 1132
(a) The Chairman of the Workers' Compensation 1133
Commission or his or her designee; 1134
(b) The State Personnel Director, or his or her 1135
designee; 1136
(c) The Commissioner of Insurance, or his or her 1137
designee; 1138
(d) The Commissioner of Higher Education, or his or her 1139
designee; 1140
(e) The State Superintendent of Public Education, or 1141
his or her designee; 1142
(f) The Executive Director of the Department of Finance 1143
and Administration, or his or her designee; 1144
(g) The Executive Director of the Mississippi Community 1145
College Board, or his or her designee; 1146
(h) The Executive Director of the Public Employees' 1147
Retirement System, or his or her designee; 1148
(i) The Executive Director of the Mississippi Board of 1149
Pharmacy, or his or her designee; 1150
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( * * *j) Two (2) appointees of the Governor whose 1151
terms shall be concurrent with that of the Governor, one (1) of 1152
whom shall have experience in providing actuarial advice to 1153
companies that provide health insurance to large groups and one 1154
(1) of whom shall have experience in the day-to-day management and 1155
administration of a large self-funded health insurance group; 1156
( * * *k) The Chairman of the Senate Insurance 1157
Committee, or his or her designee; 1158
( * * *l) The Chairman of the House of Representatives 1159
Insurance Committee, or his or her designee; 1160
( * * *m) The Chairman of the Senate Appropriations 1161
Committee, or his or her designee; and 1162
( * * *n) The Chairman of the House of Representatives 1163
Appropriations Committee, or his or her designee. 1164
The legislators, or their designees, shall serve as ex 1165
officio, nonvoting members of the board. 1166
The Executive Director of the Department of Finance and 1167
Administration shall be the chairman of the board. 1168
(3) The board shall meet at least monthly and maintain 1169
minutes of the meetings. A quorum shall consist of a majority of 1170
the authorized voting membership of the board. The board shall 1171
have the sole authority to promulgate rules and regulations 1172
governing the operations of the insurance plans and shall be 1173
vested with all legal authority necessary and proper to perform 1174
this function including, but not limited to: 1175
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(a) Defining the scope and coverages provided by the 1176
insurance plan; 1177
(b) Seeking proposals for services or insurance through 1178
competitive processes where required by law and selecting service 1179
providers or insurers under procedures provided for by law; and 1180
(c) Developing and adopting strategic plans and budgets 1181
for the insurance plan. 1182
The department shall employ a State Insurance Administrator, 1183
who shall be responsible for the day-to-day management and 1184
administration of the insurance plan. The Department of Finance 1185
and Administration shall provide to the board on a full-time basis 1186
personnel and technical support necessary and sufficient to 1187
effectively and efficiently carry out the requirements of this 1188
section. 1189
(4) Members of the board shall not receive any compensation 1190
or per diem, but may receive travel reimbursement provided for 1191
under Section 25-3-41 except that the legislators shall receive 1192
per diem and expenses, which shall be paid from the contingent 1193
expense funds of their respective houses in the same amounts as 1194
provided for committee meetings when the Legislature is not in 1195
session; however, no per diem and expenses for attending meetings 1196
of the board shall be paid while the Legislature is in session. 1197
SECTION 18. If the application or operation of any section, 1198
subsection, paragraph, sentence, clause, word or provision of this 1199
act shall be enjoined or otherwise made inoperative by a court of 1200
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competent jurisdiction on the grounds that state or federal law 1201
invalidates the application or operation thereof, this act shall 1202
be valid and effective in all other applications and operations, 1203
and no section, subsection, paragraph, sentence, clause, word or 1204
other provision shall on account of any pending litigation be 1205
deemed invalid or ineffective except as to that language which has 1206
been enjoined or otherwise made inoperative, then only until the 1207
injunction is removed. 1208
SECTION 19. This act shall take effect and be in force from 1209
and after July 1, 2026. 1210