NCPA supports state efforts for PBM reform

NCPA February 23, 2022

  • Hawaii: NCPA submitted a letter of support for Hawaii HB 1783, which would give the insurance commissioner stronger enforcement authority over PBMs. The bill was heard by the House Committee on Health, Human Services, & Homelessness, which decided to defer it.

  • Virginia: NCPA submitted a letter in support of HB 560, which would prohibit a PBM from engaging in patient steering. The committee voted to continue the bill to 2023.

  • Michigan: NCPA provided virtual comments on a substitute version of Michigan HB 4348, a PBM reform bill. NCPA focused its comments on the changes in the substitute version and their impacts on the legislation’s intended protections. The legislature passed the bill and Gov. Whitmer signed it into law.

  • South Dakota: The Senate Health and Human Services Committee voted SB 163 out of committee. This legislation would prohibit PBMs from reimbursing non-affiliate pharmacies less than affiliate pharmacies, allow a pharmacist to decline to dispense if the reimbursement is below acquisition cost, prohibit PBM imposed fees and retroactive claim adjustment or “clawbacks,” provide for MAC appeals, and prohibit discriminatory payments for 340B prescriptions. The bill will now move to the full Senate for further consideration. NCPA’s written testimony can be found here.