SB 2677 Mississippi Senate · 2025 Regular Session

Pharmacy Benefit Prompt Pay Act; define requirements for pharmacy benefit managers and pharmacy services administrative organizations.

The Pharmacy Benefit Prompt Pay Act requires pharmacy benefit managers (PBMs) to pay pharmacies promptly for medications and establishes a process for pharmacies to appeal if payments are below agreed rates. It also bans PBMs and pharmacy services organizations (PSAOs) from restricting patient choice of pharmacy, spreading pricing, or retaliating against pharmacists who exercise rights under the law. The bill mandates that PBMs, PSAOs, drug manufacturers, and health insurers report pricing and contract details to the Mississippi Board of Pharmacy, which will publish this information online for transparency. These changes directly affect pharmacies, pharmacists, PBMs, PSAOs, and health insurers operating in Mississippi.

Issues: ✓ Healthcare

Bill status died 3 of 5 stages cleared

Introduction

Feb 2025

Committee Review

Feb 2025

Senate Passage

Feb 2025

House Passage

Governor

Introduced Feb 18, 2025 Last action Mar 4, 2025

Maddy AI version diff · 2 comparisons

What changed between versions

Committee Substitute → Current version · 8 edits

MODERATE

This bill update clarifies definitions related to pharmacy benefit managers and plan sponsors, extends administrative appeal timeframes, adds new restrictions on patient out-of-pocket costs, and modifies reporting requirements for drug price increases. The changes aim to improve transparency in pharmacy benefit management and strengthen consumer protections.

Scope change

The bill's applicability remains focused on pharmacy benefit managers, PSAOs, and plan sponsors operating in Mississippi, with no major changes to which entities are covered.

DEFINITION

Definition of 'Plan sponsors' was expanded to include health maintenance organizations and clarify contracting arrangements with pharmacy benefit managers.

Definition of 'Rebate' was expanded to more clearly include payments from offshore group purchasing organizations and clarify what constitutes a rebate.

REQUIREMENT

Administrative appeal timeframe was changed from 'less than 30 days' to 'no less than 30 business days' to give consumers more time to appeal decisions.

New provision prohibits pharmacy benefit managers from charging patients amounts exceeding what the pharmacy retains, limiting spread pricing.

New requirement mandates that pharmacy benefit managers pay clean electronic claims within 7 days and paper claims within 35 days.

Drug manufacturer reporting threshold was reduced from 12-month 10% increase to 12-month 10% increase for drugs with wholesale acquisition cost of $70 or more.

ENFORCEMENT

Penalty provisions were modified to clarify that penalties collected support board operations related to regulating pharmacy benefit managers.

TECHNICAL

Various formatting and markup inconsistencies were corrected throughout the document.

As Introduced → Committee Substitute · 8 edits

MODERATE

This bill was amended to strengthen protections for pharmacies and patients under Mississippi's Pharmacy Benefit Prompt Pay Act. The Committee Substitute adds new definitions, expands reporting requirements for drug manufacturers and pharmacy benefit managers, and clarifies rules around reimbursement rates and appeal processes. The changes aim to increase transparency, prevent discriminatory practices, and ensure timely payment to pharmacies.

Scope change

The bill now explicitly includes Pharmacy Services Administrative Organizations (PSAOs) alongside pharmacy benefit managers in many provisions, and clarifies that certain entities like insurance companies and Medicaid contractors are exempt from some requirements.

DEFINITION

Added new definitions for 'spread pricing', 'referral steering', 'clean claim', and clarified existing definitions to include PSAOs and exclude certain entities like Medicaid contractors from specific obligations.

REQUIREMENT

Requires drug manufacturers to submit quarterly reports on wholesale acquisition costs and annual reports on R&D costs, rebates, and new drug pricing rationale.

Mandates pharmacy benefit managers and PSAOs to file annual reports detailing rebates, fees, and payments received from drug manufacturers, with confidentiality protections for specific plan and patient information.

Requires pharmacy benefit managers to provide reasonable administrative appeal procedures for pharmacies challenging reimbursement rates below pharmacy acquisition cost.

Prohibits pharmacy benefit managers and PSAOs from engaging in spread pricing, referral steering, or retaliating against pharmacies for exercising rights under the act.

ENFORCEMENT

Expanded the Board of Pharmacy's authority to conduct audits, issue subpoenas, and impose monetary penalties for violations, including provisions for independent consultant audits.

TIMELINE

Establishes effective date of July 1, 2025, and includes sunset provisions for certain sections expiring on June 30, 2028.

ELIGIBILITY

Clarifies exemptions for self-insured plans, facilities serving only employer employees, and certain insurance entities from specific provisions.

Floor votes · Senate Feb 13, 2025

How they voted

50–0

Passed · 1 other

Total votes 51

Feb 13, 2025

D Democratic16

16 Yea

100% Yea

R Republican35

34 Yea 1

97% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Feb 18, 2025

Committee

Referred To State Affairs;Accountability, Efficiency, Transparency

lower

Feb 18, 2025

Introduced

Transmitted To House

upper

Feb 13, 2025

Upper · Passed

Passed

upper

Feb 13, 2025

Amended

Amendment Failed

upper

Feb 4, 2025

Upper · Passed

Title Suff Do Pass Comm Sub

upper

Jan 20, 2025

Committee

Referred To Public Health and Welfare

upper

1 primary · 14 co-sponsors