This bill establishes comprehensive regulations for pharmacy benefit managers (PBMs) and pharmacy services administrative organizations (PSAOs) in Mississippi, aiming to increase transparency and prevent unfair practices in prescription drug pricing. The bill prohibits “spread pricing,” where PBMs charge health plans more for prescription drugs than they reimburse pharmacies, and requires drug manufacturers, PBMs, PSAOs, and health insurers to submit quarterly and annual reports to the Mississippi Board of Pharmacy detailing drug pricing, rebates, and other financial information. The legislation mandates that the Board of Pharmacy develop a public website to publish these reports, with protections to keep confidential business information private. The bill also prevents PBMs and PSAOs from retaliating against pharmacies or pharmacists who challenge their practices, provides a process for pharmacies to appeal reimbursement rates, and gives the Board of Pharmacy the authority to conduct investigations, issue subpoenas, and impose monetary penalties of up to $25,000 per violation for non-compliance. Additionally, the bill requires PBMs and PSAOs to disclose any ownership affiliations with pharmacies and mandates full disclosure of rebates to plan sponsors. The legislation will take effect on July 1, 2025, and is set to stand repealed on June 30, 2028, allowing for potential review and renewal.