Virginia bill aims to stop PBMs from squeezing pharmacies

Health insurance; pharmacy benefits managers; requirements and prohibited conduct.

Introduced· 2026-01-14

Who's it for

Who's it for: Everyday People

What it means for you

8/10Helps you

Good for everyday people ·

Cost shift

Plain‑English summary, cross‑checked against the official bill text.

The bill would stop health insurers and PBMs from denying pharmacies preferred status, cutting reimbursements, or charging extra fees, protecting patients and pharmacists.

Our take

What we think, in plain words.

If passed, Virginia residents could see lower drug costs and more pharmacy choices, while pharmacists gain fair pay and can stay in networks without unfair penalties.

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The facts

What the bill actually says, no spin.

PBMs cannot deny a pharmacy preferred network status if it meets the same terms as others.
PBMs cannot retroactively lower reimbursement for a covered claim except for fraud or audit corrections.
PBMs cannot charge pharmacists fees for claim processing beyond reasonable costs.
PBMs must let pharmacies share price differences with patients.
The Attorney General can seek civil penalties up to $5,000 per violation.