Now that the ink of the Governor’s pen is dry on the final bills of the 2025 Legislative Session, I am pleased to report that meaningful and robust Pharmacy Benefit Manager reform is now the law of the land in Iowa! I am very grateful for Governor Reynolds choosing to stand with patients and pharmacies over the fear mongering of the big insurance lobby. By signing this bill, the Governor has ensured that more Iowans will retain access to pharmacy services in their communities. Thank you, Governor!

Getting this bill across the finish line was a big lift and I’m grateful for Iowans across our state making their voices heard that it’s time to reign in the egregious and abusive practices of PBMs in our state.

What does SF 383 do?

• Prohibits a PBM or insurer from discriminating against a pharmacy if the pharmacy is acting within its license and all laws.

• Prohibits the removal of pharmacy choice or imposing any monetary advantages or penalties that result in removing pharmacy choice (including unnecessary specialty drug designations and requiring use of mail order pharmacies).

• Prohibits additional cost-sharing on the insured based on where they choose to have their prescription filled.

• Requires all rebates to be returned to the employee plan sponsor.

• Requires any amount paid by the insured for the prescription drug to be applied to their deductible

• Requires PBMs to reimburse retail pharmacies (not large national chains and those with only mail order) based on acquisition cost.

• Prohibits spread pricing.

• Requires pharmacies have an appeals process if not reimbursed at acquisition cost.

• Requires regular reporting from the PBMs to the Insurance Division.

• Requires a study of Pharmacy Services Administrative Organizations and wholesales by IID with a report due by January 1, 2026.

I’m grateful for the opportunity to work hard on your behalf in Des Moines. Please reach out to me about any questions, concerns or suggestions at brett.barker@legis.iowa.gov.