New Missouri 340B Grantee-PBM Law Takes Effect Tomorrow
August 27, 2026William Newton, Editor-in-Chief340B Report
A new Missouri law prohibiting pharmacy benefit managers (PBMs) and health insurers from “discriminating” against 340B grantee covered entities and their pharmacies will take effect on Friday.
Missouri’s law (Section 376.417), which Gov. Mike Kehoe (R) signed on July 13, bars PBMs and health insurers from discriminating against 340B grantees by reimbursing them differently or imposing additional terms and conditions based on their participation in the program. The law also prohibits PBMs and insurers from “refusing to cover” 340B drugs and “requiring a covered entity to identify, either directly or through a third party, a 340B drug.” It does not apply to 340B hospitals.
Missouri will join more than 30 states that have enacted PBM-340B provisions—though the scope and language of those laws vary. The new statute is separate from the state’s 340B contract pharmacy access law enacted in 2024, which did not include 340B-PBM provisions.
How We Got Here
Missouri legislators enacted the new 340B-PBM measure through separate House (H.B. 2372) and Senate (S.B. 878) healthcare packages that contained identical 340B language. Those two provisions then merged to become Section 376.417.
State Rep. Tara Peters (R) introduced the House bill on Jan. 7, which then passed the chamber 129-20 on April 2 and the state Senate 26-5 on May 13. The wide-ranging healthcare package also included insurance prior authorization transparency, contraceptive access and non-opioid treatment provisions, among others.
Peters previously sponsored the state’s 2024 contract pharmacy law and vocally criticized the misleading efforts within her party to tie the 340B program to immigration and abortion.
Meanwhile, state Sen. Travis Fitzwater (R) introduced the Senate bill on Jan. 7. That bill, which also included unrelated pharmacy prescribing provisions, unanimously passed the Senate 28-0 on March 3 and the state House 132-13 on May 11.
Kehoe announced his signing of H.B. 2372 and S.B. 878, along with four other healthcare bills, in a July 13 press release. He said the bills “will improve healthcare services for Missourians across [the] state,” though the release did not specifically mention the 340B-related PBM provisions.
What They Said
Katie Reichard, a spokesperson for the Missouri Primary Care Association, which represents state federally qualified health centers (FQHCs), praised Peters for sponsoring H.B. 2372. She also credited state Sen. Mike Bernskoetter (R) for handling the legislation in the Senate.
“Both were instrumental in ensuring our anti-pickpocketing language was included and ultimately passed the legislature, despite attempts by various insurance carriers to thwart our efforts,” she said in an email to 340B Report.
Reichard also praised Fitzwater and state Rep. Bennie Cook (R), who handled S.B. 878 in the House, stating that they “similarly prioritized the needs of FQHCs and their ability to leverage 340B savings to benefit patients and communities.”
“To have this language pass in two pieces of legislation is evidence of how supportive the [Missouri] legislature is of FQHCs and the patients they serve,” she added.
A Missouri Hospital Association spokesperson declined to comment on the bills, noting that their 340B-related provisions generally did not affect hospitals.
The Missouri Insurance Coalition, which testified against H.B. 2378 in April, did not respond to a request for comment.