The House unanimously passed a bill to give the Insurance Commissioner explicit authority to investigate and impose sanctions on pharmacy benefits managers who do not follow the reporting law.
Pharmacy Benefits Managers (PBMs) act as a pharmaceutical middle management between health care providers, pharmacies and prescription drug companies/manufacturers by negotiating the costs of those prescriptions. They can also assist providers by creating formularies (list of authorized prescriptions). In return, the pharmaceutical middle management keeps a portion of the money paid by the customer and/or health care provider that would otherwise be returned to the pharmacists in the form of a rebate.
The Legislature sees the Insurance Commissioner as an important tool for consumer protection to allow the Commissioner to look into the pricing methodology to see if the PBMs were taking financial advantage of their position, which could explain some of the high costs of prescription drugs and why some pharmacies closed.
House File 395 passed the House and is now ready for debate by the Senate.