PUTT’S Model Legislation Update: Proposed Pharmacy and Pharmacy Patient Protection Act Garners Public Sector Support at ALEC
Last month PUTT presented our proposed model legislation, the Pharmacy and Pharmacy Patient Protection Act (PPA), at the 48th annual meeting of the American Legislative Exchange Council (ALEC) in Salt Lake City, UT. The presentation before ALEC’s Health and Human Services Committee marks the second time our proposed policy has been heard and debated by the committee, which comprises more than 200 members from the public and private sector. We owe a debt of gratitude to Sen. Nancy Barto (R-AZ) who sponsored our bill and went to bat for its necessity both before and after our presentation and to Miguel Rodriguez of the Texas Pharmacy Business Council, who co-authored and helped present the bill.
ALEC, for those not familiar, favors limited government, free markets, and federalism - but if the reaction during the Q & A section of our presentation is any indication, even the most staunch “limited government” ALEC members see the need to rein in the largest PBMs from their massive overreach in the marketplace.
There’s much to say about the PPA, and why PUTT opted to go “all in” on attempted passage and adoption of this model policy language at ALEC. I’ll do my best to break it down in this post, but as always, please feel welcome to contact me directly with questions and comments.
Cutting directly to the chase, the PPA was tabled a second time, but was well-received and roundly supported by many of the public sector members present. A number of state legislators spoke with us afterward, voicing their support and asking questions about next steps on the bill. More than one legislator expressed concern that the PPA didn’t go far enough, and should do more to protect pharmacies and patients (to which we say, “Yes! We agree!”)
The inspiration for the Pharmacy and Pharmacy Patient Protection Act came from Georgia’s HB 233 and HB 918 -- both sponsored by pharmacy champion Representative David Knight -- landmark legislation seeking to end patient steering by PBMs to PBM-owned pharmacies. The PPA similarly seeks to end patient steering and certain other “bad” behaviors that serve no one but PBMs and their seemingly conscience-less or perhaps simply uninformed shareholders.
While the PPA is model legislation, acceptance from ALEC would mean endorsement from an organization whose influence is especially favorable among “red” states. Many of these states rely on their rural community pharmacies as healthcare hubs for residents, and as such cannot afford to have them squeezed out of business because a handful of very large pharmacy benefits managers can make more money mandating mail order pharmacy.
But why this model for model legislation?
Well, back in the day when I first started working with PUTT (4 years ago), we thought licensure and oversight would be enough to curb the enthusiastic abuses PBMs were perpetrating on small business pharmacies at the expense of patients, plan payers and taxpayers. We soon learned licensure was a bit esoteric - good in theory, but impractical against oligopolists who’d mastered the art of making billions by exploiting every possible loophole in the name of “proprietary” and “trade secret” business practices.
As I explained to Kansas Rep. Will Carpenter minutes before our presentation, we once thought we could fight for transparency and it would be enough to catalyze systemic reform. We now see the pharmacy industry must fight for the basic rights most other industries take for granted: the right to sell (dispense) a product and at the very least recoup the acquisition cost of the product; the right to develop and keep a customer base; and the right to participate in a provider network without being charged exorbitant fees; the right to do the work required by our profession without being charged. (What other industry has to pay the payer in order to be paid?)
The PPA has opposition, primarily from PCMA. But we are confident moving into ALEC’s policy meeting in December that we will continue to gain support among the public and private sector, and will continue to keep you updated on our progress in the subcommittee meetings leading up to the next presentation.
Until next month,