NCPA to OPM: Mandate PBM transparency
ALEXANDRIA, Va. — The National Community Pharmacists Association on Monday issued a number of recommendations to the U.S. Office of Personnel Management, which is responsible for contracting with at least two multistate plans that will offer coverage through exchanges that come online in 2014, and that will provide consumers with additional health insurance options.
Included in those recommendations were a call to include transparency requirements for pharmacy benefit managers and a call for the inclusion of "any willing pharmacies" in any multistate exchange plan.
“Successful healthcare reform places a premium on transparency, and nowhere is that needed more than in the administration of prescription drug services by the PBM industry,” NCPA EVP and CEO Douglas Hoey said. “The federal health-reform law includes just such a provision in the state healthcare exchanges. These disclosure requirements allow health plan sponsors to actually ensure PBM promises of efficiency and savings are occurring. It also will help prevent the $371 million in legal settlements that have been paid out by PBMs to address allegations of questionable practices.”
Hoey added, “This approach should be extended to all health plans, and other PBM reform bills such as The Pharmacy Competition and Consumer Choice Act (S. 1058/H.R. 1971) and The Preserving Our Hometown Independent Pharmacies Act (H.R. 1946) should also be enacted.”
Enacting these "common-sense solutions" will independent community pharmacists to play a greater role in reducing costs and improving outcomes, Hoey added.