Area pharmacists pleased with passage of Senate Bill 5
Senate Bill 5 received final approval Monday and was sent to Gov.
The state contracts with Medicaid managed care organizations, who in turn subcontract with pharmacy benefit managers (PBMs). In turn, PBMs determine how much
Independent pharmacists said PBMs connected to large pharmacy corporations such as CVS Caremark have been dramatically undercutting small pharmacies on reimbursements, and small pharmacies were in danger of going out of business if PBMs continued to set the reimbursement rate.
During a hearing on the bill in February, Sen.
Pharmacists from the
"I think the final bill, in and of itself, is an outstanding piece of legislation," said
The bill gives the state
"I think, with the transparency (requirement), it's going to be a lot of work," Henry said. "But what I think we are going to find is our independent pharmacies are going to be able to not only stay afloat, but will be able to flourish a little bit again.
"I applaud the legislators for educating themselves, trying to understand the root of the problem and trying to address it quickly," Henry said.
"In some ways, I like the (House) substitute better than the original bill, because it forces (PBMs) to show their numbers, where the money is going," Ashby said. "... It will be very interesting to know what those numbers will show."
Ashby said, "I think there's a lot of hope" from smaller pharmacies with the bill's passage. Independent pharmacies, which contract with PBMs for Medicaid reimbursement, put themselves at risk when they advocated for the bill, Ashby said.
"But after (PBMs) push reimbursements so far, you either go down fighting, or you go away," Ashby said, "and we were not willing to go away."
While contracts included provisions that pharmacists were not to discuss reimbursement rates, "I came to the conclusion that if I didn't do something, they were going to shut me down anyway," Henry said. "Everyone who was politically active on this risked their (contracts) with the PBMs."
The
Senate Bill 5 "will hopefully help out a lot, since Medicaid is a huge portion of the independent pharmacy business," Shockley said.
Future concerns facing small pharmacies include "vertical integration," where large companies involved in health care purchase other providers. For example, CNBC reported Sunday that
In that case, an insurance company owned by a corporation in the pharmacy business could require people with their insurance plans to use only their pharmacies, Shockley said. Pharmacists would need to lobby to prevent those kind of mergers, he said.
Senate Bill 5, "is a good victory for us this year," Shockley said. "But there are other things we ... will have to try to fix in the future."
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