NCPA supports legislation across the nation

NCPA May 23, 2022

New York: A med sync bill, NY A187, is moving through the legislature. The bill, which would allow for medication synchronization in the state’s Medicaid program, has passed both chambers.

Oklahoma: Gov. Kevin Stitt (R) signed SB 737 into law. The legislation protects patients and pharmacies from PBM abuses by giving the insurance commissioner greater enforcement authority over PBMs, prohibiting the practice of spread pricing, and prohibiting pharmacy network participation fees.

Tennessee: NCPA joined the Tennessee Pharmacists Association and other pharmacy advocacy groups on a letter to Tennessee Gov. Bill Lee (R) urging him to sign SB 2458/HB 2661 into law. The bill has passed both chambers and is awaiting the governor’s signature. The bill would require PBMs to adopt reimbursement methods that accurately reflect actual acquisition costs and protect patients from being forced to use PBM-owned pharmacies.

Texas: In testimony to the Texas House of Representatives’ Insurance Committee, NCPA General Counsel Matthew Seiler said that given recent court rulings including the Rutledge v. PCMA Supreme Court case, Texas can take comfort in extending its existing commonsense laws regulating pharmacy benefit managers so they also apply to PBMs serving self-funded ERISA plans. In Rutledge, the Supreme Court determined that the federal ERISA statute does not preclude Arkansas from protecting patients and local businesses by regulating PBMs serving these plans. This decision has since been reflected in PCMA v. Wehbi, which supports North Dakota’s right to regulate PBMs.

“In the wake of Rutledge, there is growing consensus that states should exercise their authority to regulate PBMs — regardless of the type of plan that the PBM is serving,” Seiler wrote in his comments as prepared for delivery. “Even before the Supreme Court decided Rutledge, the federal government, 46 states, including the state of Texas and the District of Columbia, filed briefs with the Supreme Court arguing that states have robust authority to regulate PBMs.”

Vermont: NCPA submitted a letter urging Vermont House members to concur with amendments made by the Senate to H. 353. The Senate version of the bill addresses patient steering and also requires the state to look into issues such as reimbursement transparency, spread pricing, and other PBM practices that raise costs. The House concurred with the Senate version, and the bill now awaits Gov. Phil Scott’s (R) signature.