Legislative Update Week 11:
Long Days in the Homestretch

From Ben Ross, PharmD
President, GPhA Board of Directors
 
Welcome to our eleventh weekly Legislative Update Newsletter of the 2025-2026 Georgia General Assembly Legislative Session.

Key Events This Week: 

There are “only” six of the forty Legislative Days left. This is 15% of the total days and the final push.  (Un)arguably, 75% of the work to get bills over the finish line happens in these six days. 

Monday, March 24 is a travel, rest, reset day. While it is not an official committee day, some committees may meet.
Tuesday, March 25 is Legislative Day 35, with the Senate and House both starting at 10am. Keep up to date with the committee schedule here.
Wednesday, March 26 is a committee working day. Senate Health and Human Services is scheduled for a 4pm meeting; no agenda posted yet.
Thursday, March 27 is Legislative Day 36 & Friday, March 21st takes us to Legislative Day 37. 

Go ahead and mark the rest of the days on your calendar –  

• Monday, March 31 - Legislative Day 38
• Tuesday, April 1 – Committee Work Day
• Wednesday, April  2 – Legislative Day 39
• Thursday, April 3 – Committee Work Day
• Friday, April 4 - Legislative Day 40 Sine Die!  

As a refresher, the Rules committee in both chambers are the last hurdles before a bill advances to a floor vote. House Rules Committee, chaired by Rep. Butch Parrish (R-Swainsboro), generally meets in the morning before the legislative day starts to set a calendar for that day, and/or the next day and/or a supplemental calendar (as in, adding more bills to the agenda). House Rules can and will call additional meetings and add bills continually. Senate Rules, chaired by Sen. Matt Brass (R-Newnan), generally meets after the Senate has adjourned for the day and establishes a calendar for the next legislative day. The Senate generally does not set supplemental calendars.  

Why is this important? HB 196 is currently in the Senate Rules committee waiting for its selection to go to the floor. HB 196, establishing reimbursements rates for the State Health Benefits Plan (SHBP) and the University of System of Georgia (USG), passed out of Senate Insurance and Labor last week. Several changes were made before getting out of committee, including adding a definition of Independent Pharmacy as “an entity contracted with the PBM pursuant to an agreement with a single retail pharmacy, or is contracted with the PBM through a pharmacy services administrative organization.” It would change the reimbursement rate for independent pharmacies to NADAC plus $11.50 and adjust chain pharmacies to NADAC plus $10.50. Once a bill has crossed over into the opposite body someone from that chamber will “carry” the bill from there. Chairman Matt Brass will be carrying HB 196 in the Senate.  

Since HB 196 was substituted in the Senate Committee after it passes to the Senate floor, it will need to go back to the House for an Agree or Disagree. Our goal is for an Agree in this case, which means the House agrees to the Senate Substitute. If there is a Disagree it goes back to the Senate who can either “insist” or “rescind." If the Senate insists on its version, then a Conference Committee (more on that below) is appointed to work through the differences and come to an agreement. In the end, the version voted on by each Chamber must be the same bill. This is why in these next six voting days and ten working days so much can happen.

Thank you to everyone that has taken action to keep this bill moving! Over these next ten working days, keep asking your Representative and Senator to pass HB 196 and support fair reimbursement to ensure independent pharmacies can keep serving their patients and their communities.

One last parliamentary step is the agree, disagree and conference committee process. If a bill is changed by the non-originating chamber, the originating chambers must “agree” to the changes made by the other body. If it's a House bill, the original sponsor will make a motion to “agree to the Senate Substitute to HB XX” and the bill will head over to the Governor's desk for his signature. If the original sponsor motions to “disagree with the Senate Substitute to HB XX” it would then be up to the Senate to stand firm on their version of the bill or agree to the House version.

If neither chamber agrees to a version of the bill from the other chamber, a conference committee will be called. A conference committee will be three members from each chamber, appointed by the Speaker and Lt. Governor. These members are the bill sponsors, Committee chairs, and a third member, usually from chamber leadership. The Budget, HB 68, always goes to Conference Committee for final negotiations. 

One bill to keep our eyes on is SB 140, sponsored by Sen. Greg Dolezal (R-Cumming), which would allow optometrists to use, dispense and sell pharmaceutical drugs to treat eye conditions and diseases. SB 140 was substituted in committee to add the requirement that optometrists “(V) Comply with the requirements under Code Section 26-4-130 and the rules and regulations established pursuant thereto by the State Board of Pharmacy.” It was reported in committee that this change was at the request of GDNA. SB 140 is currently in House Rules awaiting action.  


 

In that same House Health Committee, SB 91, sponsored by Sen. Blake Tillery (R-Vidalia), had robust discussion. SB 91 would prohibit Georgia’s state employees' health insurance plan from contracting with pharmacy benefit managers (PBMs) that own or have an ownership interest in any retail pharmacy or any legal entity that contracts or uses a PBM that owns or has ownership interest in a retail pharmacy.  

Dr. Dean Burke, Chief Medical Officer at the Department of Community Health (DCH) and former senator, along with Lori Garner, RPh, Director of Pharmacy Services, State Health Benefit Plan, responded to questions from the committee. Dr. Burke reported that DCH is able to respond and adapt if this bill passes and that there may be additional cost concerns. If the “Big 3” -- CVS/Caremark, ExpressScripts and OptumRx -- are unable to bid on the program, smaller PBMs may have a higher cost to administer the program statewide. The current contract with CVS/Caremark is being renegotiated as an extension to December 31, 2026, in response to questions around SB 91 and other legislation. Its original expiration date was December 31, 2025. DCH anticipates starting the Request for Proposals (RFP) process on a new contract this summer.  

Several committee members had questions concerning possible areas of cost savings, including reviewing specialty pharmacies payment differential, the state creating their own PBM, and the cost of losing Independent Pharmacies in communities vs. the cost for using a smaller PBM. Follow the money and see where it goes.  

No vote was taken on SB 91 as it was “hearing only.” You can watch the hearing at this link.