Written by Brittany LaPorta, Director of Government Affairs
Behind the scenes, EPN’s Government Affairs team monitored, analyzed, and advocated on thousands of bills across the country this session — below are three of the bigger ones that broke through. Here’s where things stand.
Tennessee — FAIR Rx Act (SB 2040): Signed into law by Governor Bill Lee, May 22, 2026.
Tennessee’s Freedom, Access and Integrity in Registered Pharmacy Act goes further than almost any PBM reform passed anywhere in the country — it bars any entity from owning a pharmacy while also owning both a health insurer and a PBM (above 5% stake), striking at the vertical-integration model that’s let PBM-affiliated pharmacies out-earn independents. CVS is suing to block it — a fight we’re watching closely — but Tennessee just proved structural reform is politically achievable. Takes effect July 1, 2028.
New York — Patient Access to Pharmacy Act (A5882): Passed both chambers, awaiting Governor Hochul’s signature.
New York’s PAPA cleared the Assembly and Senate this session and now sits on the Governor’s desk. If signed, it would require PBMs to pay pharmacies at least the National Average Drug Acquisition Cost (or actual pharmacy acquisition cost, if higher) plus a professional dispensing fee no lower than what the state’s own Medicaid program pays. In plain terms: PBMs would finally have to stop reimbursing below what it costs a pharmacy to acquire the drug in the first place.
This bill has been years in the making, and it directly answers the “rebate pumping” dynamic that’s hollowed out community pharmacy margins — where manufacturers raise list prices to feed bigger rebates back to the PBM, while the pharmacy on the front line gets left holding underwater reimbursements.
Predictably, PBM trade groups are sounding the alarm about cost increases. We’d simply note: a pharmacy that closes its doors doesn’t lower anyone’s costs either.
We’re now shifting focus to the Governor’s desk. If your pharmacy operates in New York, this is the moment to reach out and voice support — signatures happen because governors hear from constituents, not just lobbyists.
West Virginia — HB 5430: Signed into law, April 1, 2026 (effective immediately).
West Virginia continues to lead on PBM reform and oversight, and HB 5430 adds real teeth to the state’s existing framework.
Highlights:
PBMs can no longer bill payers more than NADAC (plus the state’s $10.49 dispensing fee) for a drug — closing a loophole that let PBMs pocket the difference between what they charged plans and what they paid pharmacies.
The Public Employees Insurance Agency (PEIA) is now barred from contracting with any PBM that owns or is affiliated with a licensed West Virginia pharmacy.
PBMs managing Medicaid pharmacy benefits can’t reimburse their own affiliated pharmacies more favorably than independents for the same drug or service.
The bill also requires the Insurance Commissioner to study and report on the true cost of dispensing every two years — giving future advocacy a stronger, data-backed foundation.
The Bigger Picture
Three states, three different tools —structural separation in Tennessee, a reimbursement floor in New York, spread-pricing and self-dealing restrictions in West Virginia — but the same underlying message: legislatures are done taking PBM talking points at face value and they’re willing to act on the data independent pharmacy has been putting in front of them for years. Thank you for making this possible.
But a bill signed is not a bill enforced. A law is only as strong as a Department of Insurance’s willingness to hold PBMs to it, and that’s where our focus turns next. We’ll be pushing state insurance departments to actively monitor compliance, investigate violations, and hold PBMs accountable. The work doesn’t stop here — we’ll keep pushing, and we’ll keep you posted along the way.
Brittany LaPorta is EPN’s Director of Government Affairs. Brittany manages and coordinates state legislative and regulatory advocacy efforts for EPN that protect the interests of community pharmacies. Brittany earned her master’s degree in public administration from West Virginia University. She has years of experience in government affairs, specifically public policy and government relations.