Patients, pharmacists, physicians, and others rally for PBM reform September 16.
NACDS RxIMPACT is calling on YOU to crank up the volume on the critical need for pharmacy benefit manager (PBM) reform bill SB 966 that's been heralded in hundreds of advocate letters and even a press event this week.
The press event comes at an important moment – marking the little time Governor Gavin Newsom has left to sign this bill into law. If the legislation is not signed within the next twelve days, by September 30, PBM reform will slip out of our hands despite approvals from both the California State Assembly and Senate. We must take all actions to tell the Governor to sign the bill into law!
The National Association of Chain Drug Stores collaborated with the California Pharmacists Association, California Chronic Care Coalition, and others to host a Monday, September 16 press event to send a clear message to Governor Newsom to sign SB 966 into law. Patients, pharmacists, physicians, and others gathered at the San Francisco press event with bill author State Senator Scott Wiener to showcase the merits of the legislation and profound impact unfair PBM practices have on communities. To compliment these efforts, hundreds of advocates have also sent letters calling for Governor Newsom to sign SB 966 into law.
California PBM reform is not something we can leave to chance. This means it’s “go time” yet again and NACDS RxIMPACT is calling for your help RIGHT NOW telling Governor Newsom to make the bill law as Californians and their pharmacies need PBM reform TODAY. We see this every day: PBMs profit exorbitantly while driving up Americans' prescription drug costs, while reducing Americans' access to medications and pharmacies, and while forcing pharmacies to close - chains and independents alike. Estimates project PBMs more than doubled revenue over the last decade and will do so again – reaching $800+ billion by decade’s end. Things continue to worsen!
This important legislation:
Protects Patient Choice of Pharmacies: Pharmacies not owned by a PBM can participate in a PBM network as preferred provider if the pharmacy is willing to accept the same terms/conditions that the PBM set for PBM-owned pharmacies as a condition of preferred network participation status.
Preserves Patient Access to Pharmacies: California's Attorney General retains all authorities to maintain or restore competitive, fair, and honest markets and prosecute state and federal antitrust and unfair competition violations. Licensing PBMs would create regulatory pathways and subsequent enforcement mechanisms to help ensure fair and transparent processes. Licensing PBMs may also benefit patients by lowering drug prices, improving quality of care, and expanding access to medications.
Addresses Higher Health Care Costs: Prohibits a PBM from directly or indirectly retroactively deny or reduce a claim after the claim has been adjudicated, unless: the original claim was submitted fraudulently or because the pharmacy or pharmacist had already been paid for the pharmacist services. Prevents PBM from charging a fee to process a claim electronically.
Delaying PBM reform would allow PBMs to continue to overcharge employers, raise healthcare costs for taxpayers, and force pharmacies to close. A recent Washington study showed for a subset of matched claims between the plan sponsor and the pharmacies, the average plan sponsor (employer) costs were approximately $165,000 higher (80% more) than the reimbursement provided to pharmacies (about $8 more per prescription). (Washington Health Alliance/Washington State Pharmacy Association - 3 Axis Advisors Study).
ACT TODAY! Simply enter your contact information in the right column, place “one click”, and the system will generate personalized communications to Governor Newsom. If you have any questions or would like any assistance, please contact Heidi Ecker via telephone at 703-837-4121 or email at hecker@nacds.org.