Both Iowa HF 852/SF 383, PBM reform legislation, successfully passed the first important hurdle by advancing out of the House Committee on Commerce and the Senate Committee on Health and Human Services, respectively. These bills include significant reforms permitting patient choice of pharmacy; prohibiting a PBM from reimbursing a pharmacy in an amount less than NADAC plus a professional dispensing fee in the amount of $10.60; requiring a process for pharmacies to appeal a reimbursement rate for a specific prescription; and requiring a pass-through pricing model to help ensure that payments received by the PBM for providing services are used or distributed pursuant to the PBM’s contract with the payor or with the pharmacy.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.