SB 1000, legislation to strengthen and further regulate Medicaid Managed Care PBMs was introduced by Senators Judy Ward (R) and Tina Tartaglione (D). The legislation got further momentum this week when Gov. Josh Shapiro (D) delivered his budget address and expressed the need to further regulate PBMs: “Drug companies keep raising prices, but we often don’t know why, because the middlemen negotiating those drug prices between your health insurance company and drug manufacturers don’t have to report enough information to the Insurance Department. Those middlemen are called Pharmacy Benefit Managers – or PBMs – and they have made record profits on the backs of Pennsylvanians. It’s time to reform the operation of PBMs. We’re doing our part – we need legislation to go further.” NACDS assisted in-state partners in drafting the bill and is working with them to advance it.
Also in Pennsylvania, the Department of Human Services (DHS) issued MA Bulletin 01-24-03, updating the prior authorization process for opioid use disorder treatments.
Finally in Pennsylvania, the state released an urgent bulletin stating that the Pharmacy Naloxone Copay Assistance program has been suspended due to funding issues but also indicated that it is seeking a solution.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.