Iowa’s Senate File 383 (2025) sets a NADAC-plus-fee floor. Per the Iowa Insurance Division’s implementing bulletin, PBMs must reimburse Iowa retail pharmacies at no less than NADAC — or the wholesale acquisition cost where NADAC is unavailable — plus a $10.68 dispensing fee, effective July 1, 2025, with a pharmacy appeals process under Iowa Code § 510B.8E.
One enforcement nuance: a federal court has issued a preliminary injunction halting enforcement against the ERISA-plan plaintiffs in a pending lawsuit (Iowa Association of Business and Industry v. Ommen). The law remains enforceable against everyone not party to that case.