Ohio governor signs PBM transparency law

NCPA July 21, 2019

Ohio Gov. Mike DeWine (R) on Thursday signed HB 166, which brings much-needed transparency to the state's Medicaid managed care system while also containing protections for Medicaid beneficiaries and the pharmacies that serve them. Last year, the Ohio auditor found that PBMs were pocketing an astounding $224.8 million a year from the managed care program through deceptive spread pricing practices alone. The state will contract with a single PBM starting in July 2020, with the goal of ending this abuse of taxpayer dollars, and will reinvest $100 million into the pharmacy community in the form of supplemental dispensing fees. Also under the bill, the PBM will be prohibited from requiring a patient to use its specialty pharmacy, and pharmacies will be able to appeal to the state Medicaid agency with any disputes over MAC pricing. Find more information about the bill and its patient and pharmacy protections on the Ohio Pharmacists Association's website. Congratulations to OPA and all pharmacy advocates in Ohio for this hard-fought win!