The Senate approved a bill on Wednesday that would support struggling rural pharmacies by improving pricing transparency for prescription drugs and ensuring they are reimbursed for the full cost of prescriptions for Medicaid patients, according to Senator Dan Laughlin, who supported the legislation.
In recent years, many rural pharmacies endured severe cuts to reimbursement rates from pharmacy benefit managers. Several rural pharmacists testified during a Senate Majority Policy Committee workshop discussion that the reimbursement rates they received were lower than the cost of the drug in some cases, forcing the pharmacy to operate in the red.
House Bill 941 would ensure pharmacies are reimbursed at a rate no less than the cost of the drug. The bill also improves transparency by allowing the Legislative Budget and Finance Committee to conduct a study analyzing prescription drug pricing under the medical assistance managed care program. The study will also include an overview of reimbursement practices involving pharmacies, pharmacy benefit managers and other entities that are involved in providing pharmacy care to Pennsylvanians.
In addition, the legislation would prevent pharmacy benefit managers from including confidentiality agreements or gag clauses in contracts with pharmacies to prevent information from being shared with the Department of Human Services.
House Bill 941 was amended in the Senate and sent back to the House for consideration. If the House agrees to the Senate amendments, the bill would be sent to the governor to be signed into law.
The bill builds on recent progress to protect prescription drug consumers. Earlier this year, lawmakers approved the Consumer Prescription Drug Pricing and Freedom Disclosure Act to allow a pharmacy or pharmacist to provide information about the cost of a prescription drug to consumers, including the individual’s share of costs.
The law also prohibits a pharmacy benefit manager from penalizing a pharmacy or pharmacist for disclosing this information to the individual or selling a more affordable alternative.
Contact: Matt Azeles mazeles@pasen.gov