State Advocacy Roundup - PBM Bills Continue to Progress in Numerous Key States
State efforts to address harmful PBM practices are continuing to gain momentum across the country, with numerous states considering PBM-related legislation this session. Here are some recent state advocacy highlights:
California Bill Continues to Progress in Assembly
ATAP is pleased to report that AB 2863, introduced by California Assembly Member Adrin Nazarian, has passed unanimously out of the Committee on Business & Professions. AB 2863 would limit the amount a health carrier or PBM may require a beneficiary to pay at the point of sale for a covered prescription to the lowest available cost, whether it is the applicable cost-sharing amount or the retail price. Importantly, it also requires that the patient’s deductible and out-of-pocket maximum are applied in the same manner as if they had purchased the medication by paying the cost sharing amount.
ATAP has actively supported the bill and sent a letter to the members of the Committee on Business & Professions urging them to vote in favor of AB 2863. The bill now heads to the Committee on Appropriations, where a hearing has not been scheduled.
Missouri House of Representatives Passes PBM Bill, Headed to Senate
Missouri bill HB 1542 recently cleared an important hurdle when it was passed unanimously by the Missouri House. The bill, introduced by Representative Lynn Morris, now heads to the Senate for its consideration. HB 1542 would prohibit PBMs from charging a patient a co-payment for a prescription that exceeds the amount retained by the pharmacist from all payment sources for filling the prescription. It would further ban gag clauses by prohibiting PBMs from banning pharmacists from discussing cost information with patients and informing patients if their medication would be cheaper without insurance. Finally, it specifies that PBMs cannot charge a pharmacy for any fee that is related to a claim unless the amount of the fee has been disclosed at the time of the claim's adjudication. ATAP urges the Senate to protect Missouri patients and pass this bill into law.
Maryland Joins Numerous Other States, Enacts Gag Clause Legislation
Earlier this month, Maryland enacted a bill aimed at regulating PBM practices, joining the numerous other states that have passed similar PBM legislation this session. The newly enacted law prohibits PBMs from restricting the ability of pharmacists to provide customers with cost information and from selling a more affordable alternative if one is available. ATAP applauds the Maryland General Assembly and Governor Hogan for supporting the legislation and putting Maryland patients first.
Tennessee Takes Important First Step in Regulating PBMs
SB 1852, a Tennessee bill sponsored by Reps. Ferrell Haile and Dennis Powers, was passed by the General Assembly and will now head to Governor Bill Haslam for his signature. The bill seeks to increase transparency in the PBM industry by requiring any person operating as a PBM to be licensed by the department of commerce and insurance.
ATAP encourages everyone in Tennessee to contact Governor Haslam and urge him to sign SB 1852 into law, by either email or phone at (615) 741-2001.
As always, ATAP will continue to actively support PBM-related legislation in states across the nation. Please continue to check the ATAP website for updates on the status of PBM reform efforts throughout the country. If you have additional questions or would like more information on state legislation or ATAP efforts in general, please do not hesitate to contact ATAP staff.