Insurers urged to prioritize prescription access

As Rite Aid stores across Pennsylvania continue to close, the Pennsylvania Insurance Department (PID) today urged health insurers and pharmacy benefit managers (PBMs) to take immediate steps to protect patients' access to prescription medication as many Pennsylvanians look for a new pharmacy.

"As Rite Aid stores continue closing across the Commonwealth, we are asking insurers and PBMs to do everything they can to ensure Pennsylvanians' prescription access is smoothly transitioned to other pharmacies," said Pennsylvania Insurance Commissioner Michael Humphreys. "We know these closures are stressful, but if insurers, PBMs and pharmacies work together, we can make sure that Pennsylvania families can obtain the care and medications they need without having to deal with unnecessary red tape."

Through Notice 2025-07, posted online today, PID reminded Insurers and PBMs that network adequacy rules are in place to protect consumers. Insurers, and in some cases PBMs, are legally required to provide patients with reasonable access to pharmacy services. Any health insurer that is unable to meet the Commonwealth's time or distance standards related to pharmacy access for patients affected by a Rite Aid closure should contact PID immediately.

PID Urges Insurers and PBMs to:

Help patients quickly find a new pharmacy if their local Rite Aid has closed;

Allow a patient to use out-of-network pharmacies when in network pharmacies are not available and, make sure patients do not pay more than in-network prices in such cases;

Transfer any existing approvals or prior authorizations to the new pharmacy automatically—patients should not have to reapply;

Set up hotlines, websites, or other support tools to make prescription transfers easy;

Fast-track urgent requests, like specialty medications and controlled substances; and

Pause or reschedule pharmacy audits, so local pharmacies can focus on helping more patients during this busy time.

Pennsylvanians who had their Rite Aid pharmacy close should contact their insurance company first. However, if consumers do not receive a response or have issues accessing their prescriptions, they are encouraged to visit pa.gov/consumer or call 1-866-PA-COMPLAINT.

Questions regarding this notice may be directed to the Bureau of Health Coverage Access, Administration, and Appeals at [email protected] or by calling 717-787-4192, toll-free at 888-466-2787.

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