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House passes PBM reform after negotiated amendment aimed at protecting community pharmacies
Summary
The House approved Senate Bill 252, aimed at increasing reimbursement fairness for community pharmacies, after adopting a committee substitute and a negotiated floor amendment that allows private employers flexibility in how they handle PBM rebates.
The Alabama House on April 8 passed Senate Bill 252, legislation lawmakers and supporters say is intended to improve reimbursement and preserve access to community pharmacies — especially in small and rural towns.
Sponsor Representative Rigsby told the chamber the bill targets practices by pharmacy benefit managers (PBMs) that have contributed to independent pharmacy closures. The committee substitute that reached the floor removed the bill’s private right of action and eliminated a sunset for the reimbursement provisions, changes the sponsor described as part of negotiated changes with stakeholders. The House later adopted a floor amendment by Representative Laverne that clarifies a private‑sector employer’s ability to negotiate with a PBM over how manufacturer rebates are treated — either passed through directly to the employer or counted as part of an administrative fee — without reducing protections for independent pharmacies.
Representative Gidley and others who spoke in favor said the bill will help small businesses and patients maintain access to local pharmacies. Multiple members recounted messages and meetings with pharmacists in their districts. Several representatives urged rapid passage; the sponsor and other leaders negotiated language intended to secure broad support across employer groups, insurers and pharmacy organizations. The House adopted the committee substitute and the floor amendment on recorded votes, then gave final passage as substituted and amended.
Vote and process: The House recorded adoption of the committee substitute (Aye 103, Nay 0), adoption of the floor amendment (Aye 103, Nay 0), and final passage of SB 252 as substituted and amended (Aye 102, Nay 0). House leadership described the amendment as the result of months of study and meetings with stakeholders and an off‑session PBM study group.
What the amendment does: The floor amendment explicitly permits employers or plan sponsors that negotiate directly with PBMs to treat rebates either as direct rebate dollars returned to the sponsor or as part of the PBM’s administrative fee. Supporters said that preserves contract flexibility while the underlying bill addresses reimbursement fairness for community pharmacies.
Why it matters: Independent and rural pharmacies have pressed lawmakers for relief amid closures. Sponsors argued SB 252 will help keep pharmacies open and protect access to medications for seniors and rural residents. Opponents in earlier phases had argued for different remedies; the version the House adopted removes a private right of action and other provisions to win broader backing.
What’s next: SB 252 goes to the Senate (or to the enrolling process if it already passed the Senate). Stakeholders said they expect administrative and contractual work between employers, PBMs and pharmacies to follow as the law is implemented.
