Duane Morris Online Article – October 22, 2025

On October 11, 2025, California Governor Gavin Newsom signed Senate Bill 41 (SB 41) — one of the nation’s strongest laws regulating pharmacy benefit managers (PBMs). While this law directly affects California, its impact will ripple far beyond the state, influencing how other states — including Maryland, Virginia, Florida, Pennsylvania, and Hawaii — approach PBM reform and pharmacy reimbursement fairness.

What SB 41 Does

SB 41 is designed to curb unfair PBM practices, strengthen transparency, and protect independent pharmacies. Key provisions include:

1. “Any Willing Provider” Access

PBMs can no longer exclude non-affiliated pharmacies willing to accept the same contract terms as affiliated ones. The law also bans patient steering, discriminatory reimbursement, and restrictions on mail-order or local delivery — ensuring patients can choose their pharmacy freely.

2. End of Spread Pricing

Beginning January 1, 2026, PBMs must use a passthrough pricing model, eliminating the hidden profit “spread” between what payors pay and what pharmacies receive. This helps restore fairness and transparency to reimbursement.

3. No More Retroactive Clawbacks

SB 41 bans PBMs from reducing payments through reconciliations or post-adjudication fees, except in cases of fraud or billing error — giving pharmacies stable, predictable revenue.

4. Ethics and Transparency Requirements

PBMs must act in good faith, disclose conflicts of interest, report detailed financial data, and provide 30 days’ notice before changing or terminating contracts. Violations can result in fines of up to $7,500 per incident, enforceable by the California Attorney General.

Why It Matters Beyond California

California’s reform joins a growing national movement — from Arkansas and Maine to Texas and Maryland — to rein in PBM dominance and restore access to care.
For independent and workers’ compensation pharmacies, this trend represents a turning point:

• Fair Access: More states are adopting “any willing provider” rules.

• Fair Payment: Spread pricing bans are becoming the standard.

• Accountability: PBMs are being held to the same ethical and financial standards as other healthcare entities.

As these reforms spread, pharmacies in every state should prepare by reviewing PBM contracts, documenting retroactive payment practices, and engaging with local lawmakers to support similar legislation.

What It Means for RescueMeds and the Patients We Serve

At RescueMeds, we believe injured workers and first responders deserve immediate access to care — not PBM delays or denials.
California’s SB 41 strengthens that mission by affirming that pharmacies providing timely, essential medications should be treated fairly and paid transparently.

RescueMeds continues to advocate for similar reforms across the country — ensuring that patients, not profit margins, come first.

Key Takeaway

SB 41 is more than a California law — it’s a model for nationwide PBM reform.
For independent and workers’ comp pharmacies, it signals a shift toward fairness, transparency, and patient-centered care.

As states follow California’s lead, pharmacies that prepare now will thrive in the future of fair reimbursement.

RescueMeds’ Perspective

At RescueMeds, we share Cuban’s urgency. Transparency, fair reimbursement, and patient-first policies are critical to fixing the broken pharmacy system. Injured workers—already vulnerable—face unnecessary barriers created by PBMs and corporate middlemen.

Our mission is clear: deliver medications directly to patients quickly, at no cost to them, and without PBM interference. We believe trust in healthcare starts with transparency—and patients deserve nothing less.

Join us today.  Sign the Petition, send us your email and let’s hold PBMs accountable by requiring transparent costs and keep local pharmacies in our neighborhoods.