A July 26 U.S. Senate Finance Committee review of pharmacy benefit manager (PBM) reform legislation signals a BIG opportunity to advance bipartisan reforms that address the needs of Medicare and Medicaid patients and their pharmacies. NACDS RxIMPACT needs your immediate help urging U.S. Senators to use their role to support and advance real PBM reform TODAY!
Late last week the Committee announced it will determine the fate of PBM reform bills under its jurisdiction. It is crucial two bills consistent with the Committee’s Bipartisan Framework for Reducing Prescription Drug Costs are supported and advanced on July 26: The Drug Price Transparency in Medicaid Act (S. 1038) and The Protect Patient Access to Pharmacies Act (S. 2052). ALL provisions of BOTH bills are vital for real PBM reform, and for addressing ‘pharmaceutical benefit manipulation’ that harms the most vulnerable in the Medicaid and Medicare programs.
The U.S. House Energy and Commerce Committee’s Subcommittee on Health included the House companion of S. 1038 – the Drug Pricing Transparency in Medicaid Act (H.R. 1613) – into the broader PATIENT Act (H.R. 3561), which was unanimously approved by the Committee. Help NACDS RxIMPACT tell your U.S. Senators it is critical to protect ALL Medicare and Medicaid beneficiaries and the pharmacies that serve them by including ALL S.2052 and S.1038 language in any PBM reform measure!
The Protect Patient Access to Pharmacies Act (S.2052) by U.S. Senators Jon Tester (D-MT), Shelley Moore-Capito (R-WV), Sherrod Brown (D-OH), and James Lankford (R-OK) would reform pharmacy DIR fees that are jeopardizing seniors, pharmacists, pharmacies, and communities, and it would enforce “any willing pharmacy” requirements. The Drug Pricing Transparency in Medicaid Act (S.1038) by U.S. Senators Peter Welch (D-VT) and Roger Marshall (R-KS) would crack down on tactics by which “pharmaceutical benefit manipulator” middlemen maximize profits over patients by prohibiting “spread pricing” in Medicaid and establishing a “pass-through payment” model. Both bills embrace key aspects of NACDS’ Principles of PBM reform.
As seen in the video, PBM “pharmaceutical benefit manipulators” profit at the expense of patients, pharmacies, employers, taxpayers, and communities. PBM retroactive fees and claw backs – known as DIR fees – occur months after transactions close and devastate rural and urban pharmacies’ economic viability. Fees have risen 107,400% between 2010 and 2020, with pharmacy payments to PBMs up 50.4% from 2018 to 2020. Contrary to PBMs’ claims, The Centers for Medicare & Medicaid Services’ Calendar Year 2024 Part D Final Rule did not end pharmacy DIR claw backs.
Join this NACDS RxIMPACT effort TODAY to urge your U.S. Senators to ensure ALL components of S. 2052 and S. 1038 are incorporated in any PBM reform measure to put patients and the pharmacies that serve them ahead of PBM profits! To act, simply enter your contact information, click "Send Message" and the system will send personalized messages to your U.S. Senators. If you have any questions or would like any assistance, please contact Heidi Ecker via telephone at 703-837-4121 or email.
Late last week the Committee announced it will determine the fate of PBM reform bills under its jurisdiction. It is crucial two bills consistent with the Committee’s Bipartisan Framework for Reducing Prescription Drug Costs are supported and advanced on July 26: The Drug Price Transparency in Medicaid Act (S. 1038) and The Protect Patient Access to Pharmacies Act (S. 2052). ALL provisions of BOTH bills are vital for real PBM reform, and for addressing ‘pharmaceutical benefit manipulation’ that harms the most vulnerable in the Medicaid and Medicare programs.
The U.S. House Energy and Commerce Committee’s Subcommittee on Health included the House companion of S. 1038 – the Drug Pricing Transparency in Medicaid Act (H.R. 1613) – into the broader PATIENT Act (H.R. 3561), which was unanimously approved by the Committee. Help NACDS RxIMPACT tell your U.S. Senators it is critical to protect ALL Medicare and Medicaid beneficiaries and the pharmacies that serve them by including ALL S.2052 and S.1038 language in any PBM reform measure!
The Protect Patient Access to Pharmacies Act (S.2052) by U.S. Senators Jon Tester (D-MT), Shelley Moore-Capito (R-WV), Sherrod Brown (D-OH), and James Lankford (R-OK) would reform pharmacy DIR fees that are jeopardizing seniors, pharmacists, pharmacies, and communities, and it would enforce “any willing pharmacy” requirements. The Drug Pricing Transparency in Medicaid Act (S.1038) by U.S. Senators Peter Welch (D-VT) and Roger Marshall (R-KS) would crack down on tactics by which “pharmaceutical benefit manipulator” middlemen maximize profits over patients by prohibiting “spread pricing” in Medicaid and establishing a “pass-through payment” model. Both bills embrace key aspects of NACDS’ Principles of PBM reform.
As seen in the video, PBM “pharmaceutical benefit manipulators” profit at the expense of patients, pharmacies, employers, taxpayers, and communities. PBM retroactive fees and claw backs – known as DIR fees – occur months after transactions close and devastate rural and urban pharmacies’ economic viability. Fees have risen 107,400% between 2010 and 2020, with pharmacy payments to PBMs up 50.4% from 2018 to 2020. Contrary to PBMs’ claims, The Centers for Medicare & Medicaid Services’ Calendar Year 2024 Part D Final Rule did not end pharmacy DIR claw backs.
Join this NACDS RxIMPACT effort TODAY to urge your U.S. Senators to ensure ALL components of S. 2052 and S. 1038 are incorporated in any PBM reform measure to put patients and the pharmacies that serve them ahead of PBM profits! To act, simply enter your contact information, click "Send Message" and the system will send personalized messages to your U.S. Senators. If you have any questions or would like any assistance, please contact Heidi Ecker via telephone at 703-837-4121 or email.
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