NCPA Reveals Resource to Streamline Reporting of State PBM Law Violations

Health care middlemen must be made to follow laws on the books, NCPA says

NCPA May 10, 2022

ALEXANDRIA, Va. (May 10, 2022) – With virtually every state having enacted some type of pharmacy benefit manager regulation, ensuring that these policies are actually being enforced is becoming increasingly important. The National Community Pharmacists Association is launching a new resource to help pharmacists and patients report possible violations to state insurance regulators and push them to enforce the laws on the books.

In developing this new resource, NCPA state policy staff compiled information on PBM laws in each state and included links to all states’ department of insurance complaint forms. Perhaps a state has a law prohibiting PBMs from clawing back funds from pharmacies after the point of sale, for example, or banning PBMs from steering patients to pharmacies owned by or affiliated with that PBM. NCPA’s PBM Complaints tool will make it easier for taxpayers who experience these PBM actions in violation of state law to formally report them to their insurance regulator to be investigated and made compliant.

“There have been great strides forward in recent years with comprehensive state PBM reforms and court victories, but patients, small-business pharmacies and taxpayers aren’t seeing all of this progress when regulators aren’t enforcing the laws,” says Anne Cassity, NCPA vice president of federal and state government affairs. “With NCPA’s PBM Complaints tool, we want to make it easy for people to thoroughly report possible infractions so these officials have no excuse for inaction.”

Click for NCPA’s PBM Complaints tool.

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Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ approximately 215,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit www.ncpa.org.

NCPA