This week, both the House Commerce Subcommittee and the Senate Health and Human Services Subcommittee recommended passage of HSB 99 and SSB 1074, respectively. These companion bills relate to PBMs, pharmacies and prescriptions drugs. Among the various provisions includes patient choice of pharmacy. Also, a PBM shall not deny a pharmacy or pharmacist the right to participate as a contract provider if the pharmacy or pharmacist agrees to the terms and requirements of the plan. Additionally, a PBM shall not require a person, as a condition of payment or reimbursement, to purchase pharmacy services exclusively through a mail order pharmacy. Finally, the bill prohibits a PBM from reimbursing a pharmacy in an amount less than the National Average Drug Acquisition Cost (NADAC) or the Iowa average acquisition cost for a prescription on the date the prescription is administered or dispensed, and the PBM also must reimburse the pharmacy or pharmacist a professional dispensing fee in an amount not less than the pharmacy dispensing fee published in the Iowa Medicaid Enterprise provider fee schedule on the date the prescription is administered or dispensed.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.