NCPA's state government affairs team tirelessly tracks and engages with state legislation and regulation across the country, with our priorities including comprehensive PBM reform, PBM regulation enforcement, and Medicaid managed care reform. Here's a breakdown of our recent state government affairs activity relating to pharmacy reimbursement.
- An amended version of Louisiana HB 1236 cleared the Senate and was returned to the House for concurrence. The bill requires commercial market reimbursement of NADAC plus a professional dispensing at or above the Medicaid fee-for-service rate. NCPA also continues to watch Louisiana SB 387, which assigns fiduciary responsibility to PBMs, requires passthrough of rebates, and provides audit protections to pharmacies. An amended version of the bill is through the House and now returns to the Senate for concurrence.
- New Jersey A 1502 has cleared the Assembly chamber. It would require a reimbursement floor of NADAC plus the Medicaid professional dispensing fee of $10.92 in the commercial market, state employee and school employee health plans, and the Medicaid managed care program. The Assembly vote came quickly on the heels of a successful Assembly Appropriations Committee hearing, for which NCPA submitted written comments.
- Virginia Gov. Abigail Spanberger (D) vetoed prescription drug affordability board legislation HB 483/SB 271, the first such legislation that NCPA did not oppose due to its appropriate recognition of how pharmacies are reimbursed for both product and dispensing.
- NADAC-plus legislation in Oklahoma, SB 2074, died when legislators did not override the veto of Gov. Kevin Stitt (R).
- New York A 5882, legislation to require commercial market reimbursement of at least NADAC plus the Medicaid professional dispensing fee was approved by the Assembly Insurance Committee. The bill now heads to the Assembly Ways and Means Committee.
- NCPA checked in with stakeholders in Texas ahead of next week’s scheduled interim Senate Health and Human Services Committee meeting that will look at prescription drug costs, including the role of PBMs.
NCPA
