Ensuring access to fair and reasonable pharmacy networks
Impact
The enactment of S687 will likely enhance patient experiences in obtaining prescriptions, as pharmacies will not be unfairly excluded from networks based on arbitrary standards. The requirement that pharmacy benefit managers must allow pharmacies to participate in their networks if they agree to the same terms as existing members is a significant step towards increasing fairness in pharmacy accessibility. This change can potentially reduce patient costs and improve health outcomes by allowing more pharmacies to operate on equal footing.
Summary
Bill S687, titled 'An Act ensuring access to fair and reasonable pharmacy networks', was introduced to improve the accessibility and fairness of pharmacy benefit manager networks. The bill amends existing laws to require pharmacy benefit managers to maintain an adequate network of pharmacies that can provide prescription drugs within a reasonable distance for patients. It seeks to ensure that patients have convenient access to pharmacist services and medications without undue restrictions imposed by the managers.
Contention
Despite its intentions, the bill faces potential contention related to the practices of steering. 'Steering' refers to the practice of directing patients toward certain pharmacies that a pharmacy benefit manager may own or have a relationship with, potentially affecting patient choice. To combat this, S687 imposes a surcharge on pharmacy benefit managers that engage in such practices. This provision could result in pushback from managers who may argue that such regulations affect their business operations and profit margins. Discussions in legislative committees are expected to focus on balancing the interests of consumers and pharmacy benefit managers.
Replaced by
Order relative to authorizing the joint committee on Health Care Financing to make an investigation and study of certain current Senate documents relative to health care financing matters.
To Create The Pharmacy Nondiscrimination Act; To Require Pharmacy Benefits Managers To Accept Any Pharmacy Or Pharmacist Willing To Accept Relevant And Reasonable Terms Of Participation; And To Declare An Emergency.