Here are your top independent pharmacy news stories for the week of September 27, 2024.
PBM reform in Alaska
Alaska Governor Mike Dunleavy (R) has signed H.B. 226 into law, a bill spearheaded by the Alaska Pharmacy Association to overhaul pharmacy benefit manager (PBM) practices. The new legislation establishes a duty of care for PBMs toward plan sponsors, benefits administrators, and covered individuals, while introducing new requirements for transparency and disclosure.
The bill tackles various unfair trade practices, ensuring patients can choose their pharmacy freely, curbing patient steering, prohibiting certain fees, and mandating equal reimbursement for PBM-affiliated and non-affiliated pharmacies. It also directs the director of the Division of Insurance to create regulations setting standards for reimbursement, grievances, and appeals. The National Community Pharmacists Association (NCPA) praised the passage of H.B. 226 and congratulated AKPhA on their significant achievement.
Congress holds hearings focused on PBM reform
The House Energy and Commerce Committee recently marked up several healthcare bills, including H.R. 7623, the Telehealth Modernization Act, sponsored by Reps. Buddy Carter (R-Ga.) and Lisa Blunt Rochester (D-Del.). This bill aims to permanently extend the telehealth flexibilities introduced during the COVID-19 pandemic under Medicare, which are set to expire at the end of the year.
The committee also passed H.R. 8107, the Ensuring Access to Medicaid Buy-in Programs Act, sponsored by Reps. Juan Ciscomani (D-Ariz.) and Marie Gluesenkamp Perez (D-Wash.). It incorporates provisions from H.R. 1613, the Drug Price Transparency in Medicaid Act, focusing on National Average Drug Acquisition Cost (NADAC) reporting and reforms to pharmacy benefit managers (PBMs).
Meanwhile, the Senate Finance Committee held a hearing to review provisions of the Inflation Reduction Act related to Medicare. These include negotiating prescription drug prices, restructuring the Medicare Part D benefit, and introducing inflation rebates for drugs covered by Medicare Parts B and D. Testimony was provided by healthcare experts and stakeholders. Senators Ron Wyden (R-Ore.), Mike Crapo (R-Idaho), James Lankford (R-Okla.), and Mark Warner (D-Va.) all emphasized the importance of PBM reform during the session.
House of Representatives passes legislation regarding spread pricing
The House of Representatives passed H.R. 4758, the Accelerating Kids’ Access to Care Act, introduced by Reps. Lori Trahan (D-Mass.) and Mariannette Miller-Meeks (R-Iowa). The bill would require state Medicaid programs to establish a process for out-of-state providers to treat children undergoing additional screening. It also includes requirements for pass-through spread pricing by requiring the use of the NADAC survey.