PBMs: We're Calling Your Bluff

​It takes courage to call out cheaters, but independent pharmacies are showing courage in spades - and with inspiring results - as PBMs continue to shamelessly game the system to their own profiteering advantage. Below are just a few of the exciting victories we've been following and/or participating in since January 1:
 
Following the Florida Medicaid Analysis' jaw-dropping report of overt patient steering, specialty pharmacy abuse and PBM non-compliance with the state's Single Preferred Drug List, community pharmacists launched a series of local press conferences calling for immediate reform. Florida legislators have been gridlocked on the PBM reform issue since Rep. Jackie Toledo's HB 961, one of the state's most aggressive PBM legislation bills in years, was tabled in favor of a more neutral committee bill. Refusing to back down, independent pharmacies have scheduled press conferences at their stores over the next two weeks.

After a year-long effort to launch meaningful reforms in Wisconsin, Assemblyman Michael Schraa's AB114 PBM reform bill finally got its hearing this month - and saw the bill greatly reduced in strength just hours before the hearing. Undaunted, Wisconsin local pharmacists attended the hearing and testified with their patients, along with patient group representatives, pharmacy audit representatives, a former CVS employee and members of the public in a 6-hour hearing that stretched well into the evening. Assemb. Schraa's wife and daughter, whose treatment at the hands of PBMs prompted the bill, provided emotional testimony that left committee members asking how a bill that had garnered some 99 sponsors couldn't be passed as originally introduced. The following week, SB 100, the companion bill to AB114, had more than 4 hours of testimony from pharmacists, patients and advocates. Track AB 114 progress here.
 
In classic "zero to hero" fashion, Illinois went from virtually no protective legislation for patients and pharmacies two years ago to a series of new bills introduced this session by Senator Andy Manar.  Proposed legislation would eliminate certain underhanded practices including below-cost reimbursements and forced mail order. Sen. Manar, a tireless champion for community pharmacy, has been working closely with  independent pharmacies to bring change to a state where (for a little while at least) PBM reform seemed all but impossible.
 
With last year's victorious enactment of Senator Fred Mill's comprehensive SB 41 anti-PBM abuse legislation, Louisiana's independent pharmacies are now preparing for the possible topic of PSAO regulation - one the opposition's primary talking points - as the state's legislative session kicks off next month.  Louisiana independent pharmacies are also keenly interested in helping their fellow independent pharmacies in other states draft and pass meaningful PBM reform legislation, with the end goal of bringing state reform momentum to the federal government. 
 
California pharmacies are fighting back after the state Medicaid program decided to recoup millions lost to PBM spread pricing from pharmacies - the very people who reaped no benefit from spread pricing whatsoever. See our article (below) for how California Pharmacists Association is working to thwart Medi-Cal's misguided efforts.
 
To date more than 100 PBM legislation bills have been introduced, with more on the way. Look for updates on these and other inspiring victories in upcoming issues of this newsletter, and please contact us at info@truthrx.org for more information on how these and other states are winning against PBM abuse.