House committee advances PBM transparency bill after heated testimony on pharmacy access

The House Health Committee voted to report House Bill 919 favorably with amendments after a marathon of testimony over payment rules for pharmacies and the conduct of pharmacy benefit managers.

Sponsor Representative Echols told the committee the bill aims to "bring simple sunlight, fairness, and accountability" to a market he called "rigged" by middlemen. "If a pharmacy fills a prescription, they should get paid what it costs," Echols said, urging protections for independent, locally owned pharmacies.

Independent pharmacists and patient advocates told personal stories about access gaps and prescription denials. "The patient should have access to their choice of health‑care provider and that provider should be paid their cost to acquire and dispense the drugs — no more," said Randall Johnson of the Louisiana Independent Pharmacies Association. BJ Smith, a brain‑injury survivor, described repeated denials that threatened his continuity of care: "I can't continue my mission of helping people without my doctors and my medication," he said.

Representatives of PBMs and insurers cautioned that parts of the bill could disrupt services that rely on vertically integrated mail‑order and specialty pharmacies. Phil Cristofanelli of the Pharmaceutical Care Management Association warned the committee that the proposal could "yank licences away" from pharmacies providing mail and specialty services and harm patients served by TRICARE and other national programs. David LaVine of Louisiana Blue said initial actuarial estimates showed substantial employer cost impacts, though he acknowledged that amendment work had narrowed the bill's scope.

Committee amendments adopted in committee included: an explicit floor for a professional dispensing fee targeted to independent, physically located Louisiana pharmacies (amendment set 1876) and clarification that violations could be enforceable under the Louisiana Unfair Trade Practices Act. Committee members also accepted an amendment to remove the bill's vertical‑integration prohibition from the current text (in response to ongoing litigation in other states) so the committee could focus on reimbursement, transparency and enforcement mechanisms.

Echols said the narrower posture was intentional: "We stand with people delivering care, not the middleman squeezing them out of business." The committee's action reports HB 919 out of Health with amendments; the measure will next be scheduled for further committee work or floor action.

The hearing included extensive questioning about the bill's cost modeling and downstream effects. Witnesses asked state agencies and insurers for the underlying actuarial analyses and for clarity about which payers could lawfully absorb higher dispensing fees. The committee did not record a roll‑call vote in the transcript; the clerk announced HB 919 "reported with amendments."