ND SB 2378 Cost Analysis (2023)
Cost analysis for provisions relating to preferred networks and mail order pharmacy restrictions and a white bagging prohibition.
IA HF 729 Cost Analysis (2021)
If enacted, IA HF 729 would cost the state $1.2 billion over next 10 years. HF 729 would instittue Any Willing Provider rules and restrict
CA SB 524 Talking Points
Talking points addressing SB 524, a bill aimed at prohibiting PBM steering practices in California.
PBMS are Taking Action to Promote Patient Access to Prescription Drugs During COVID-19 Pandemic
PCMA developed overiew addressing the actions PBMs are taking to address access and affordability of prescription drugs during the COVID-19 pandemic.
AL SB 236 Talking Points (2020)
These talking points address how Alabama Senate Bill 236 will impact private contracts and restrict the tools pharmacy benefit managers use to reduce prescription drug
PCMA Oppose WA SB5744
The talking points outline PCMA’s opposition to WA SB5744 which would create a mandate that health plans establish additional procedures to administer prescription drug benefits
PBM-Pharmacy Snapshot
This document outlines the facts relating to the PBM-Pharmacy relationship. PCMA points out that Independent Pharmacies have significant bargaining clout via PSAOs and are highly
KY – HB 458 Increases Health Care Costs and Creates Patient Safety Risk
These talking points explain that HB 458 prohibits mail-order only plans and prohibits providing patients a lower copay or coinsurance as an incentive to fill prescriptions through mail-order or specialty mail-order. HB 458 will have a direct and material impact on Medicaid, the Kentucky employees’ health plan, and the fully insured, private commercial insurance market in the state.
This bill limits a health plan’s ability to use mail-order programs removes the lowest cost pharmacy option available. Employers and health plans should have access to tools that manage prescription drug costs, without government intervention. When an employer or health plan contracts with a PBM to administer their pharmacy benefit, the employer maintains authority over the terms and benefit plan design. The employer or plan – not the PBM – makes decisions regarding cost-sharing requirements, mail-service, formulary, etc. HB 458 removes the option for the employer or health plan to use mail order and specialty pharmacy mail-order as cost savings tools.