Pharmacies Face Extra Audit Burdens That Threaten Their Existence
Pharmacy benefit managers switched to virtual audits during the pandemic, which increased reviews, payment denials and their profits.
PBM
Revision of PBM Law Sails Through House Without Opposition
HB 2388 makes a previous law regulating PBMs more effective and gives state regulators the ability to police bad actors who violate the law.
The House unanimously passed legislation Wednesday morning to better regulate pharmacy benefit managers, giving enforcement powers to the Oregon Department of Consumer & Business Services, designed to ensure the PBMs act lawfully and treat pharmacists fairly.
Pharmacists on Track to Win Better Protection from PBM Abuses
House Bill 2388 will strengthen the existing regulation of pharmacy benefit managers by giving the Department of Consumer & Business Services the ability to investigate complaints and cancel a company’s registration if the PBM commits fraud or fails to pay civil penalties.
Pharmacists appear poised to add significant teeth to the state law regulating pharmacy benefit managers, persuading the Legislature to make the first changes to the law since it was enacted in 2013.
Pharmacists Push for Better Regulations to Keep PBMs Honest
Pharmacists complain that they’re still at the mercy of wildly unpredictable and unfair compensation from some pharmacy benefit managers, and face burdensome audit and appeals processes to fix unfair pricing, despite a 2013 law intended to correct PBM behavior. They want the Insurance Division to have more teeth to enforce the law as well as new rules that would not allow PBMs to pay pharmacists less than their posted price.
The Oregon State Pharmacy Association is gearing up for another run at fixing the kinks in the state laws governing pharmacy benefit managers so that these large for-profit companies won’t push the last mom-and-pop pharmacies to close their doors.
