Pennsylvania Passes Bill to Reform Pharmacy Benefit Managers

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HARRISBURG, PA — A coalition of Pennsylvania community pharmacists is celebrating the passage of House Bill 1993, a reform package aimed at regulating pharmacy benefit managers (PBMs). The bill now awaits Governor Josh Shapiro’s signature. In his February budget address, Shapiro called for PBM reform.

Protecting Local Pharmacies

PBMs are intended to negotiate lower drug prices with pharmaceutical companies. However, instead of passing these savings on to patients, health insurers, or community pharmacies, PBMs often pocket the money. This year alone, over 140 pharmacies in Pennsylvania have closed.

House Bill 1993 introduces several measures to protect patients and increase government oversight. These measures include:

  • Limits on PBM patient steering: Ensuring patients can use their local pharmacies without facing financial penalties from PBMs.
  • Comprehensive study of PBM practices: The Pennsylvania Insurance Department will oversee this study to understand and regulate PBM business operations.
  • Specialty drug definitions: Protecting access to important medications at local pharmacies.
Expanded Services at Pharmacies

The legislation also broadens services available at community pharmacies. It allows pharmacists to provide immunizations for individuals aged eight and older and authorizes pharmacists to test for Respiratory Syncytial Virus (RSV), a common and highly contagious respiratory infection.

Broad Bipartisan Support

“The broad bipartisan support for this common-sense legislation provides stronger patient protections through enhanced transparency and oversight of PBMs,” said Victoria E. Elliott, CEO of the Pennsylvania Pharmacists Association. She noted that the Insurance Department’s study would offer crucial information for further improving PBM regulation.

Elliott thanked the bill’s key sponsors: Representatives Jessica Benham (D-Allegheny) and Valerie Gaydos (R-Allegheny), as well as Senate sponsors Judy Ward (R-Blair) and Christine Tartaglione (D-Philadelphia). She also expressed appreciation for Governor Shapiro’s support.

Legislative Details

House Bill 1993 amends the Pharmacy Audit Integrity and Transparency Act. It includes provisions for PBM registration, contract requirements, cost transparency, and enforcement. The bill aims to preserve community pharmacies as viable businesses and ensure patients can choose their preferred pharmacy providers.

Next Steps

With Governor Shapiro’s expected signature, House Bill 1993 will become law, marking a significant step forward in protecting Pennsylvania’s community pharmacies and enhancing patient access to necessary medications and services.

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