Republicans look to curb prescription middlemen’s fees and practices

Florida Politics

A recent report shows that Pharmacy Benefit Managers could be costing the state hundreds of millions.
A band of Republican lawmakers hope to reel in pharmacy benefit managers and save Florida’s Medicaid program millions of dollars.

They say their legislation (SB 1306/HB 1043) would level the playing field to contest unfair practices by pharmacy benefit managers, known as PBMs. In doing so, one sponsor, Doral Sen. Ana Maria Rodriguez, said the state could save at least $143 million in the bill’s first year.

“Our pharmacies are being gouged for providing services to communities that would otherwise be left no choice and they’d suffer dire health consequences from lack of access to care,” said Rep. Jackie Toledo, a Tampa Representative who has routinely tackled issues tied to PBMs.

Stuart Sen. Gayle Harrell, who has also championed health care reform, fears neighborhoods are losing their community pharmacies to PBMs, which she called “mega organizations.”

PBMs are middlemen between health care plans and pharmacies. They help determine which drugs insurance plans will cover and negotiate on behalf of insurers to secure discounts from drug manufacturers. When a claim is filed, PBMs collect money from those plans, then pass money to pharmacies through different methods.

Former Lt. Gov. Jeff Kottkamp, who hosted Wednesday’s press conference on behalf of Small Business Pharmacies Aligned for Reform, said prescription drug costs continue to rise despite PBMs claiming they save Floridians money.
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