The 2025 Alabama Legislative Session concluded on May 14 at midnight. During the session, the Alabama Academy of Family Physicians actively represented the interests of its members on a range of healthcare initiatives. By engaging with lawmakers and key stakeholders, the Academy worked to ensure that the voices of family physicians were heard in discussions that have the potential to impact healthcare delivery and access for communities across the state.

Bill Easing Volunteer Rules for Retired Physicians Awaits Governor’s Signature

What’s in the Bill: HB 346 streamlines volunteer opportunities for retired physicians at free health clinics is headed to the Governor for final approval. Sponsored by Representative Paul Lee, the legislation removes the burdensome 100-hour annual service requirement, facilitating greater access to care for underserved communities.

What Happened: This legislation has been enacted into law.

Alabama Set to Eliminate the “Pink Tax”

What’s in the Bill: Alabama is on the verge of eliminating the sales tax on essential family items after a significant legislative victory. House Bill 152, championed by Representative Neil Rafferty and mirrored by Senate Bill 159 led by Senator Arthur Orr, has now successfully passed the Senate, overcoming previous hurdles.

This bill aims to remove the sales tax burden from vital goods such as baby bottles, baby wipes, breast milk pumping equipment, diapers, maternity clothing, and menstrual hygiene products.

What Happened: This legislation has been enacted into law.

HB 45 – Medicaid Coverage for Cologuard Test

What’s in the Bill: Sponsored by Rep. Ed Oliver, HB 45 would require the Alabama Medicaid Agency to cover any noninvasive colorectal cancer screening test assigned a grade A or B under the recommendations of the United States Preventive Services Task Force. This bill would also require the Alabama Medicaid Agency to cover a colonoscopy based on a positive test result.

What Happened: The bill passed out of the Senate and awaits the Governor’s signature.

HB 46 – Rural Physician Tax Credit

What’s in the Bill: Sponsored by Rep. Ed Oliver, HB 46 would update a rural physician tax credit aimed at attracting more doctors to practice in rural areas. The existing tax credit, established in 1993, is set to be enhanced to $10,000, doubling its previous amount. This expansion will extend eligibility to physicians residing in counties with populations of 75,000 or fewer, as well as municipalities with populations of 20,000 or less – in a county with 75,000 or less. The updated tax credit seeks to incentivize physicians to serve in underserved rural communities, addressing longstanding healthcare disparities and bolstering access to medical care for Alabama’s rural residents.

What Happened: The Senate Committee on Finance and Taxation Education did not meet to discuss the bill.

HB 86 – Rural Hospital Investment Fund Bill

What’s in the Bill: Sponsored by Rep. Terri Collins, HB 86 proposes the establishment of a Rural Hospital Investment Program in Alabama, which would serve as a conduit for financial support from the public directed towards rural hospitals in the state. To incentivize donations to these hospitals, the bill suggests creating a tax credit for individuals and entities to offset their state income tax liability. Under this program, qualifying hospitals would receive gifts to support their provision of acute care services to rural populations. These funds could be utilized for various purposes, including direct care, operational expenses, and facility maintenance or upgrades. To oversee the implementation and operation of the program, the bill would establish a board within the Office of State Treasurer. This board would determine the eligibility of qualifying rural hospitals to receive donations eligible for the tax credit and would administer the program with support from the Department of Revenue.

What Happened: This legislation has been enacted into law.

HB 477 – ALFA Health Plan Bill

What’s in the Bill: House Bill 477 would allow the Alabama Farmers Federation (ALFA) to offer health benefit plans exclusively to its members outside of state insurance regulations. Sponsored by Representative David Faulkner, the bill aims to provide more affordable health coverage options for farmers and self-employed agricultural workers who lack access to employer-sponsored plans. Key features of the bill include a 1.3% tax on premiums and mandatory coverage for essential health services such as hospitalization, emergency services, and prescription drugs.

What Happened: This legislation has been enacted into law.

SB 102 – Presumptive Medicaid Eligibility Bill

What’s in the Bill: SB 102, sponsored by Sen. Linda Coleman-Madison, D-Birmingham, would provide “presumptive eligibility” for pregnant women by allowing health care providers to determine eligibility for Medicaid based on preliminary information. The process is aimed at expediting access to prenatal care by allowing eligible women to receive Medicaid coverage and necessary medical services within the first trimester.

What Happened: This legislation has been enacted into law.

SB 252 – PBM Bill #3

What’s in the Bill: Sponsored by Sen. Billy Beasley, SB 252 is the “compromise PBM bill” between different pharmacy groups advocating for PBM Bill #1 & PBM Bill #2. This bill would prohibit pharmacy benefits managers from charging pharmacies or pharmacists miscellaneous fees related to network participation and claims processing, and from charging other fees that reduce reimbursement or increase out-of-pocket charges to health plan beneficiaries. Pharmacy benefits managers would be prohibited under this bill from barring disclosure of information by pharmacists to consumers about drug costs and alternative drugs for treatment. Pharmacy benefits managers would be further required to pass on 100 percent of rebates received from drug manufacturers to the health benefit plans for which they provide services. This bill would specify that the Commissioner of Insurance shall enforce violations by a pharmacy benefits manager, including those committed during an audit of a pharmacy under the Pharmacy Audit Integrity Act, and would provide a civil penalty. This bill would provide a civil action for pharmacists, pharmacies, and insurance beneficiaries for injuries due to violations by a pharmacy benefits manager.

What Happened: The bill was signed into law by the Governor on 4/15/2025.