State Legislation: Bill Amendments · January 8, 2026 · Primary source
MO SB 840: new version, 5302S.01I - Introduced
Summary
Missouri SB 840, introduced and referred to the Senate Insurance and Banking Committee in January 2026, requires health carriers and PBMs to count amounts paid by or on behalf of an enrollee (including manufacturer copay assistance) toward out-of-pocket maximums and cost-sharing requirements for brand medications with no available generic substitute. The bill also prohibits health carriers and PBMs from designing benefits in a way that accounts for the availability of cost-sharing assistance programs for those medications. If enacted, the provisions apply to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026.
What this may mean
Health carriers and PBMs operating in Missouri would be required to apply copay accumulator and maximizer restrictions to brand-only medications starting August 28, 2026, for newly entered or renewed plans. The bill directly constrains benefit design authority for PBMs and health plans on drugs without generic substitutes. The measure remains in committee and has not been enacted.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
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