Lauren's Legislative Update: May 2022

May 20, 2022

Many PUTT members use the summer legislative break to invite lawmakers into their stores. This is an excellent opportunity to show your elected officials how many potential voters from their district you interact with daily, so be sure to take advantage if you can.

One highly important thing to remember when discussing proposed legislation with legislators is the matter of “agreed upon bills”. This does not refer to bills "agreed upon" between Independent Pharmacies and PCMA and/or the Health Insurance Plan lobbyists. “Agreed upon bills” means bills agreed upon between business & labor groups like chambers of commerce and unions. Try to make sure you have support from entities of both sides to drive home any reform points. No one assumes we will agree upon a PCMA-supported bill.

Two states that seem to be continuously on the cutting edge of regulation and reform at the state level are Louisiana and Texas. Here are three different trends we believe should be on everyone’s radar:

Requiring PBMs to Register with the State Board of Pharmacy. Louisiana’s House Health & Welfare Committee heard Sen. Fred Mills’ SB 99, which would mandate Pharmacy Benefit Managers to register with the Board of Pharmacy due to a current Louisiana state law that clarifies some of their business operations as “the practice of pharmacy.”

Currently, Louisiana law says PBMs “may” register with the Board of Pharmacy, so we aren’t at all surprised that none of the Big 3 have done so. We all know PBMS won’t willingly register for more oversight. The BOP wants this changed to “shall” so the Big 3 would be forced to comply. This would allow the agency to get a handle on the complaints they are receiving about PBMs that the Louisiana Department of Insurance can’t enforce because PBMs operating as Third Party Administrators are outside of what can be regulated for in the state.

Other states have strengthened their Departments of Insurance to help attempt to rein in PBM practices, so we're watching to see which governmental agency will win. Keep your eyes on LA!

Texas Opens Discussion re: Implications of Rutledge v. PCMA. Representative Dr. Tom Oliverson, Chair of the Texas House Insurance Committee, held a discussion this week about the Rutledge SCOTUS decision, and how different industry experts are suggesting states pass legislation after that landmark case.

PCMA propaganda is leaving legislators wary of ERISA battles, so educating your decision makers is vital. Find the legislator in your state involved with the National Council of Insurance Legislators (NCOIL), and work with them to help educate other legislators on this issue. See Rep. Dr. Oliverson’s committee discussion here: Insurance - May 18th, 2022 (granicus.com).

Enforcement of Recently Passed Legislation. Now that legislatures are having “normal” committee hearings on items not related to election maps or the pandemic, we’re seeing more discussion on how to enforce the items that you all bravely fought to get passed. This includes Arkansas Act 900-style bills, which the Rutledge decision was based on.

In response to this quandary, Louisiana created a PBM Monitoring Advisory Council to help implement new legislation, but until recently haven’t been able to meet. Other states are also attempting to form oversight groups and/or adjust insurance code language to combat the enforcement issue. We'll be keeping a close eye out to see what unfolds and, as always, will keep you posted.

If your state is looking at any of these or other trends, please let us know at lauren@truthrx.org. More updates coming soon!