Pharmacists push to end health plan drug limits

JACKSON, Miss. -- Pharmacists want Mississippi lawmakers to force an end to limits on where people covered by certain insurance plans can get prescriptions filled.

However, lobbyists for some pharmacy benefit managers say the state can't legally regulate certain insurance plans because they're covered by federal law.

The two sides squared off Tuesday in a House Insurance Committee hearing called by Chairman Gary Chism. The Columbus Republican proposes allowing local pharmacies to match mail-order discounts given by benefit managers. Neither insurers nor independent pharmacists backed his language.

Pharmacists say too many drug plans are forcing customers to use particular mail order and retail pharmacies or else pay more. They say that if their stores can meet the terms of the drug plan, they should be able to participate, too.

"We just want an even playing field for everybody involved," said Waymon Tigrett, a pharmacist who sits on the state board and owns Brandon Discount Drugs.

The committee didn't vote Tuesday and it's unclear if any proposal will garner enough support to advance. Large pharmacy chains and drug plans say a 1996 law meant to aid independent drug stores is sufficient. They say pharmacists should complain to the Insurance Department if they see violations.

Allen Horne a lobbyist for CVS Caremark, said his company is just implementing terms of contracts desired by clients. CVS has both retail pharmacies and a mail-orders. Horne said that some plans where employers self-insure under federal law are beyond the reach of Mississippi insurance officials.

"Those are health plans that the Department of Insurance has no authority over," Horne told the committee.

Chism urged pharmacists to complain to the Insurance Department, which says it hasn't heard from anyone claiming the current 1996 law is being violated.

"Right now there haven't been any complaints, but I think some of that is because the pharmacists and the consumers haven't know where to complain," he said.

The Mississippi Independent Pharmacies Association wants the state Board of Pharmacy to regulate drug plans. Executive Director Robert Dozier said it's possible the board might be able to assert more authority over drug plans, citing a 2011 law that gives the board permission to regulate the benefit managers. Dozier said Mississippi is the only state with such a law.

"Enforcement is a really big deficiency right now," said Cliff Osbon, a pharmacist who heads Transcript Pharmacy in Flowood. That company sued the government insurance plan that covers state and public school employees in Hinds County Circuit Court. A Meridian pharmacy sued the state and won in Hinds County Chancery Court. The insurance plan has appealed the second suit to the state Supreme Court.

Two members of the Insurance Committee and at least four members of the House are current or retired pharmacists. Rep. Forrest Hamilton, R-Olive Branch, who's a retired pharmacist and isn't on the Insurance Committee, was among those who argued in favor of action.

"We need to say that big corporations have no more advantage than the small man that's helping the community," Hamilton said.

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