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A Pharmacy Benefit Overhaul in California
Reed Smith
[Guidance Overview] Oct. 24, 2025 "PBMs must move to a 'passthrough pricing model' under which the amounts paid by a plan or insurer for a covered drug are passed through in full to the dispensing pharmacy, inclusive of any contracted professional dispensing fee, without reconciliation offsets. Spread pricing is barred in contracts executed, amended, or renewed on or after January 1, 2026; any preexisting spread-pricing authorizations cannot persist into future amendments or renewals, and such terms become void on and after January 1, 2029." MORE >> |
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