New Rules for Pharmacy Benefit Managers and AIDS Drug Assistance Program Funding
December 9, 2025
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Where This Stands
Currently Chapter No. 2026-4. The next step in the legislative lifecycle is Introduced.
Procedural history
20 actions- Feb 26, 2026HouseIntroduced1st Reading (Committee Substitute 1)
- Feb 26, 2026HouseIntroducedCS Filed
- Feb 26, 2026HouseLaid on Table under Rule 7.18(a)
- Feb 26, 2026HouseReported out of Health & Human Services Committee
- Feb 26, 2026HouseCommitteeFavorable with CS by Health & Human Services Committee
- Feb 24, 2026HouseAdded to Health & Human Services Committee agenda
Show 14 earlier actions
- Jan 27, 2026HouseNow in Health & Human Services Committee
- Jan 27, 2026HouseReported out of Budget Committee
- Jan 27, 2026HouseCommitteeFavorable by Budget Committee
- Jan 23, 2026HouseAdded to Budget Committee agenda
- Jan 21, 2026HouseNow in Budget Committee
- Jan 21, 2026HouseReported out of Health Care Facilities & Systems Subcommittee
- Jan 21, 2026HouseCommitteeFavorable by Health Care Facilities & Systems Subcommittee
- Jan 16, 2026HouseAdded to Health Care Facilities & Systems Subcommittee agenda
- Jan 13, 2026HouseIntroduced1st Reading (Original Filed Version)
- Dec 16, 2025HouseNow in Health Care Facilities & Systems Subcommittee
- Dec 16, 2025HouseCommitteeReferred to Health & Human Services Committee
- Dec 16, 2025HouseCommitteeReferred to Budget Committee
- Dec 16, 2025HouseCommitteeReferred to Health Care Facilities & Systems Subcommittee
- Dec 9, 2025HouseIntroducedFiled
Version history
Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.
View official text →The Frame
The law changes how pharmacies can challenge drug reimbursement rates and mandates that the state directly distribute HIV/AIDS medications to eligible low-income residents, ensuring specific funding and reporting requirements are met through mid-2026.
Potentially affected actors named in the source documents. Mention is not a position.
Pharmacy Benefit Managers
They must comply with new transparency, reporting, and reimbursement requirements.
Pharmacies and Pharmacists
They gain new rights to appeal reimbursement rates and protections against discriminatory reimbursement practices.
ADAP Participants
They receive medication through direct distribution rather than health insurance plans through June 30, 2026.
Last recorded activity December 9, 2025.
Introduced.
Summary
Key Facts
You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.
Frequently Asked Questions
How does this law affect my pharmacy's ability to challenge drug prices?
Who is eligible for the AIDS Drug Assistance Program under this new law?
Can a pharmacy refuse to fill a prescription if the reimbursement is too low?
Why It Matters
The law changes how pharmacies can challenge drug reimbursement rates and mandates that the state directly distribute HIV/AIDS medications to eligible low-income residents, ensuring specific funding and reporting requirements are met through mid-2026.
News Coverage
Lobbying Activity
MONUMENT ADVOCACY
on behalf of COUNCIL FOR AFFORDABLE HEALTH COVERAGE
(C) MANAGEMENT INC.
on behalf of Association of Community Cancer Centers
2021
“THE TELEHEALTH MODERNIZATION ACT (H.R. 1332/ S.368) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views telehealth expansion as critical for cancer patient access to healthcare providers. THE SAFE STEP ACT (H.R.2163/S.464) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views step therapy in the use of cancer care delivery to be a hinderance to best practice and timely treatment/access of care for patients. THE ACCESS TO GENETIC COUNSELOR SERVICES ACT (H.R. 2144/S.1450) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC views genetic counselors as integral members of the cancer care delivery team in oncology programs/practices in the US. THE RESEARCH INVESTMENT TO SPARK THE ECONOMY (RISE) ACT (H.R. 869/S.289) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC understands the importance of research funding for the NIH and oncology investigators to promote clinical trials that impact improving cancer outcomes. THE MEDICARE MULTI-CANCER EARLY DETECTION SCREENING COVERAGE ACT OF 2021 (H.R. 1946) Organized a Virtual Capitol Hill Day for ACCC members (70+) on May 12th, 2021. Created one-pagers and talking points on importance of this legislation. ACCC advocates for the use and coverage of cancer screening modalities that will diagnose cancer at earlier stages therefore improving patient outcomes. MOST FAVORED NATION (Proposed by Trump Administration at end of 2020) ACCC entered into a lawsuit against HHS in December 2020 opposing the Most Favored Nation proposal tying drug reimbursements to international reference pricing. By lowering reimbursement to cancer programs and practices, patient access to care would be limited as supportive cancer care services limited due to lack of reimbursement to cover positions. ACCC was concerned over programs/practices closing if proposal were to move forward. ACCC met with one Senators office on this topic expressing concern in January 2021. RADIATION ONCOLOGY MODEL (Proposed by CMMI) ACCC met with 1 Senate office and 1 House office over concerns re: this alternative payment model. ACCC has concerns over mandatory nature of Radiation Oncology model testing reimbursement rates and potentially limiting access to care for patients who are recommended radiation for their cancer diagnosis, particularly in rural areas of the U.S. ”
Voting Record
Favorable With Committee Substitute (Health & Human Services Committee)
Total
39
Yes
37
No
0
Present
0
Not Voting
2
Abstain
0
How they voted (39)
Robbie Brackett
Republican · yes
Rob Long
Democratic · yes
Shane Abbott
Republican · yes
Will Robinson
Republican · yes
J.J. Grow
Republican · yes
Sam Greco
Republican · yes
Susan Plasencia
Republican · absent
Toby Overdorf
Republican · yes
Brian Hodgers
Republican · yes
Robin Bartleman
Democratic · yes
Daryl Campbell
Democratic · yes
Dianne Hart-Lowman
Democratic · yes
Demi Busatta
Republican · yes
Dean Black
Republican · yes
Marie Woodson
Democratic · yes
Dean Black
Republican · yes
Shane Abbott
Republican · yes
Adam Anderson
Republican · yes
J.J. Grow
Republican · yes
Will Robinson
Republican · yes
Kaylee Tuck
Republican · yes
Alex Andrade
Republican · yes
Mitch Rosenwald
Democratic · yes
Brian Hodgers
Republican · yes
+ 15 more
Favorable (Budget Committee)
Total
43
Yes
40
No
2
Present
0
Not Voting
1
Abstain
0
How they voted (43)
Demi Busatta
Republican · yes
James Buchanan
Republican · yes
Lawrence McClure
Republican · yes
Susan Valdés
Republican · yes
Felicia Robinson
Democratic · yes
Patt Maney
Republican · yes
Gallop Franklin
Democratic · yes
Fiona McFarland
Republican · yes
Jennifer Canady
Republican · yes
Jim Mooney
Republican · yes
Toby Overdorf
Republican · yes
Chuck Brannan
Republican · yes
Jenna Persons-Mulicka
Republican · yes
Traci Koster
Republican · yes
Sam Garrison
Republican · yes
Randy Maggard
Republican · yes
Jason Shoaf
Republican · yes
Will Robinson
Republican · yes
JOHN SNYDER
- · yes
James Buchanan
Republican · yes
Jim Mooney
Republican · yes
Lawrence McClure
Republican · yes
Felicia Robinson
Democratic · yes
Michele Rayner
Democratic · absent
+ 19 more
Favorable (Health Care Facilities & Systems Subcommittee)
Total
29
Yes
23
No
2
Present
0
Not Voting
4
Abstain
0
How they voted (29)
Anne Gerwig
Republican · yes
Erika Booth
Republican · yes
Dotie Joseph
Democratic · absent
Nan Cobb
Republican · yes
Gallop Franklin
Democratic · yes
Kiyan Michael
Republican · yes
Robbie Brackett
Republican · absent
Robin Bartleman
Democratic · yes
Brian Hodgers
Republican · yes
Webster Barnaby
Republican · yes
Daryl Campbell
Democratic · no
RaShon Young
Democratic · yes
JOHN SNYDER
- · yes
Kiyan Michael
Republican · yes
Adam Anderson
Republican · yes
Webster Barnaby
Republican · yes
Robbie Brackett
Republican · absent
Gallop Franklin
Democratic · yes
Jennifer Kincart Jonsson
Republican · yes
Erika Booth
Republican · yes
Anne Gerwig
Republican · yes
RaShon Young
Democratic · yes
JOHN SNYDER
- · yes
Daryl Campbell
Democratic · no
+ 5 more
Sponsors
Discoveries
Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.
Direct Medication Distribution
The law mandates a shift from insurance-based coverage to direct distribution of medications for the ADAP program through June 2026.
Connected Entities
Sources
openstates.org
Analysis Score
0–100- Significance85How much this matters to a regular citizen
- Controversy40Intensity of disagreement among stakeholders
- Entertainment10Compellingness for a non-policy-wonk reader
- Buzz30Current news / social attention level
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