Virginia Gov. Ralph Northam (D) signed HB 1291, which prohibits PBMs that administer benefits for the commonwealth's Medicaid managed care program from engaging in spread pricing. This move came after a state report found that PBMs pocketed $29 million from Virginia Medicaid. The legislation was sponsored by Del. Keith Hodges (R), an independent pharmacist who also sponsored earlier enacted legislation containing protections from PBM abuses.