Apr. 18, 2018
HARRISBURG – Reps. Doyle Heffley (R-Carbon) and Judy Ward (R-Blair) have proposed consumer protection legislation aimed at addressing common issues faced by community pharmacies.
After hearing from several community pharmacy owners about unfair reimbursement rates for Medicaid patients, Heffley is exploring solutions to ensure Pennsylvanians do not lose access to their hometown pharmacies.
Recently, pharmacy benefit managers (PBMs) have been cutting reimbursements to community pharmacies for medications sold to patients on Medicaid. This practice has led to substantial financial difficulties for community pharmacies. Heffley’s
House Bill 2212 seeks to remedy the problem.
“This issue was brought to my attention by several Carbon County residents,” said Heffley. “Our community pharmacies provide an incredibly important service to thousands of Pennsylvanians, and I want to ensure they remain viable for years to come. The one-on-one consultations and relationships built between community pharmacies and their patrons can be life-saving.”
Many of Pennsylvania’s rural areas are served by community pharmacies. In Carbon County, for example, more than half of the pharmacies are locally owned and operated.
In order to help patients get the fairest price for their prescriptions, Ward has authored
House Bill 2211, which would permit pharmacists to disclose prescription drug information to a patient that would allow the patient to get the best price for medications.
When PBMs contract with pharmacies, the documents may at times contain what is referred to as a “gag clause,” which prohibits pharmacists from disclosing information to a customer that could reduce their out-of-pocket costs for medications.
“During my research of this issue, I discovered that for many less expensive, generic medicines, co-pays can often be more expensive than if the patient simply pays out-of-pocket and bypasses insurance. Yet sometimes, a pharmacist is prevented from telling their customers about such potential savings,” said Ward. “More and more recently, local pharmacies have expressed frustration about such restrictions in their contracts with PBMs, and I too share the pharmacists’ frustration regarding this issue.”
According to the National Conference of State Legislatures, “gag clauses” have come to the attention of many state policymakers seeking to lower drug costs by requiring greater transparency at the retail pharmacy level. Between 2016 and March 2018, at least seven states enacted laws among at least 26 state legislatures that considered prohibiting gag clauses in contracts that restrict pharmacists.
“My legislation would ensure pharmacists have the right to provide an insured customer information regarding the amount of the insured’s cost share for a prescription drug,” said Ward. “I believe patients should be allowed to receive information that will save them money, especially as prescription drug prices continue to rise.”
Heffley and Ward’s bills will first be considered by the House Health Committee.
Representative Doyle Heffley
122nd District
Pennsylvania House of Representatives
Media Contact: Morgan Dux
717.260.6695
mdux@pahousegop.com
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