ATAP Applauds Virginia in Becoming First State to Pass PBM Legislation This Session

ATAP is pleased to report that a Virginia bill aimed at regulating PBMs (HB 1177), championed by Delegate Todd Pillion (R, 4th), has passed both the House and the Senate and is now headed to Governor Ralph Northam’s desk.  Should the Governor sign HB 1177 into law, Virginia will become the first state to enact PBM legislation during the 2018 session.   

Importantly, this bill would impose much needed transparency and restrictions on PBM practices with respect to pharmacies by taking aim at gag clauses and clawbacks.  More specifically, it would prohibit PBMs from requiring patients to pay a copayment amount that is more than the price they would pay if they had not used their insurance.  The bill would ensure that PBMs allow pharmacies to let patients know when a more affordable option is available and to sell them the more affordable alternative when requested. 

Finally, the bill would also limit the circumstances in which PBMs can charge a pharmacy retroactive fees for dispensing prescriptions, which often results in a net loss for the pharmacy when it dispenses certain medications.  The bill also specifies that if there is such a fee, the PBM much provide timely notification to the pharmacy.

ATAP applauds the efforts of Delegate Pillion, whose strong leadership helped guide this bill through the legislature, and wishes to thank both the Virginia House and Senate for supporting patients and pharmacies and passing HB 1177.  We strongly urge Governor Northam to sign this crucial legislation into law, and encourage everyone in Virginia to contact the Governor’s office by phone (804-786-2211) or by email (using the email submission form provided here).  

ATAP will continue to actively support HB 1177 as it is considered by the Governor.  Please continue to check the ATAP websites for updates on the status of this bill and other PBM reform efforts throughout the country.  If you have additional questions or would like more information on this legislation or ATAP efforts in general, please do not hesitate to contact ATAP staff.