NCPA supports Ore. reimbursement, audit, pharmacy choice legislation
NEW YORK — Bills introduced in Oregon's state legislature would allow employers and other health plan sponsors to have greater knowledge about how pharmacy benefit managers determine the rates at which they pay pharmacies for dispensing generic drugs; establish new standards for pharmacy audits while requiring PBMs to register in the state and be licensed by the state board of pharmacy; and prevent health plans from requiring residents of the state to use mail-order pharmacies.
S.B. 363 would allow Oregonians to fill prescriptions at the pharmacy of their choice, similar to legislation recently enacted in New York and Pennsylvania. Meanwhile, H.B. 2123, in addition to requiring PBMs to register in the state, would include the same maximum allowable cost, or MAC disclosure, and updating requirements featured in S.B. 402.
"No homebuilder would agree to build a house with knowing what they would be paid, the cost of their construction materials or whether they would be held harmless when the cost of lumber or other goods increases," National Community Pharmacists Association second VP and Grants Pass, Ore., pharmacist and pharmacy owner Michele Belcher said. "Yet that's exactly the situation that community pharmacists are in today. This bill would simply let the pharmacist know how they will be reimbursed for drugs and allows employers to better understand what makes up their drug plan costs."
In one example, at a legislative hearing, a local pharmacist reported being reimbursed less than $1.80 for a prescription for which the previous reimbursement was $8.69. Similar bills are under consideration in the state legislatures of Kentucky, North Dakota and Oklahoma.