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SB668

State pharmacy benefits manager; contractual provisions, report.

Status:
In Senate

Latest Action: Feb. 4, 2026
Senate: Fiscal Impact Statement from Department of Planning and Budget (SB668)

Chief Patron:
Aaron Rouse (D)

Session:
2026 Regular Session

Summary

As Introduced. State pharmacy benefits manager; contractual provisions; report.

Requires the Department of Medical Assistance Services' contract with the state pharmacy benefits manager to (i) require that that ingredient-cost reimbursement is based on the national average drug acquisition cost, or if unavailable, the wholesale acquisition cost minus a discount set by the Department, plus a professional dispensing fee, determined by the Department; (ii) require real-time or near real-time transparency in drug costs, rebates collected and paid, dispensing fees paid, administrative fees, and all other charges, fees, costs, and holdbacks, claim denials appeals, and network participation; (iii) prohibit the state pharmacy benefits manager from steering Medicaid recipients to affiliated pharmacies through differential cost-sharing, restrictive network design, or the mandatory use of a mail order pharmacy provider; (iv) require the state pharmacy benefits manager to (a) meet network adequacy standards established by the Department; (b) allow any willing pharmacy to participate in the pharmacy network; (c) verify that all contracted pharmacies are actively accepting Medicaid recipients; (d) submit annual reports containing certain information; (e) disclose to the Department pricing and maximum acquisition cost methodologies; and (f) allow invoice-based or national average drug acquisition cost-based appeals and require an adjustment of rates network-wide when an appeal is upheld; and (v) include enforcement mechanisms and monetary penalties for noncompliance. (Less)
  • Bill History

  • 01/14/2026 - Senate: Prefiled and ordered printed; Offered 01-14-2026 26103768D
  • 01/14/2026 - Senate: Referred to Committee on Education and Health
  • 01/29/2026 - Senate: Rereferred from Education and Health to Commerce and Labor (13-Y 0-N)
  • 01/29/2026 - Senate: Rereferred to Commerce and Labor
  • 02/02/2026 - Senate: Reported from Commerce and Labor and rereferred to Finance and Appropriations (11-Y 1-N)
  • 02/02/2026 - Senate: Rereferred to Finance and Appropriations
  • 02/04/2026 - Senate: Fiscal Impact Statement from Department of Planning and Budget (SB668)

Full text and vote history:

Virginia Legislative Information System

RichmondSunlight.com


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