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2019-2020 Legislative Priorities


Main Priority


Pharmacy Benefit Managers (PBM) Regulation and Transparency.

PPA is looking at opportunities to provide for greater transparency of pharmacy benefit managers (PBMs). 

Click here to learn more about PBM related issues.


Two US Senators request PBM pricing inquiry, citing Pennsylvania and Ohio Medicaid Programs



Auditor General, Eugene DePasquale Demands Increased Oversight of Pharmacy Benefit Managers that Impact Drug Prices





Auditor General DePasquale Holds Forum on Drug Pricing Transparency

View Press Release


Auditor General DePasquale Initiates Review to Bring Transparency, Accountability to Prescription Drug Pricing. 

View Press Release





PBM Transparency and Fair Reimbursement Package (HB 941, HB 942, HB 943, HB 944, HB 945)

Fair Reimbursement:

Click here to read Rep. Doyle Heffley's co-sponsorship memo.

Bill number 941 - Introduced by Rep. Doyle Heffley (R-122)


Spread Pricing:

Click here to read Rep. Tony DeLuca's co-sponsorship memo.

Bill number 569 - Introduced by Rep. Tony DeLuca (D-32)

Status Referred to the House Insurance Committee on 3-9-19



Prohibition of Gag Clauses:  


Click here to read Rep. Tony DeLuca’s co-sponsorship memo.  

Bill Number: House Bill 570

Status - Referred to House Health Committee 3-7-19


Prohibition of Gag Clauses to elected officials:


Click here to read Rep. Valerie Gaydos's co-sponsorship memo.

Bill Number: House Bill 943

Status - Referred to House Health Committee 5-19



When pharmacy benefit managers (PBM’s) contract with pharmacies, the contracts usually contain a gag clause, which prohibits pharmacists from disclosing information to their patients that could substantially reduce the patient’s out-of-pocket costs for their prescription medications.  For example, for many less expensive, generic medicines, co-pays can often be more expensive than if the patient simply paid out of pocket and bypassed their insurance.  PPA has worked hard to have legislation introduced that will allow pharmacists to disclose prescription drug information to a patient that would allow the patient to get the best price for all of their medications.  This sounds like a reasonable expectation – to pay the lowest price for your prescription medications, doesn’t it? Some of these gag clauses also prohibit a pharmacist from sharing their concerns with elected and appointed officials. This legislation will ensure pharmacists have the right to provide an insured customer with information regarding the amount of the insured's cost share for a prescription drug and will also give pharmacists the right to share with elected officials data as well as concerns for their patients.


Authority to Audit Subcontracts with Pharmacy Benefit Managers:

Click here to read Rep. Johathan Fritz's co-sponsorship memo 

Bill Number: House Bill 944




This  legislation will allow for a full-scale audit of subcontracts with pharmacy benefit managers (PBMs) in Medicaid.

Almost 90 percent of Pennsylvania Medicaid patients are served by managed-care companies that contract with the state. In turn, those companies contract with PBMs for their pharmacy programs to decide which drugs will be covered and how much to reimburse the pharmacies that fill the prescriptions. According to the Department of Human Services, Pennsylvania taxpayers paid nearly $3 billion to PBMs for Medicaid enrollees in 2017.

Since contracts between managed-care companies and PBMs are not signed directly with the state and are instead subcontracts, there is no provision requiring that they be made available for anyone to review, including the Department of the Auditor General. Therefore, we do not know how this money is being used, regardless of the fact that these are taxpayer dollars. There is a need for greater transparency, and this legislation will provide just that. 



Medication Synchronization:

Bill Number: House Bill 195 - Introduced by Rep. Eric Nelson (R-57)



  • HB 195 passed the House unanimously on 2/4/19. 
  • It is currently in the Senate Banking and Insurance Committee. 


Medication synchronization is when a pharmacist works with a patient to synchronize medication refills so that all of their medications can be picked up on the same day each month, instead of having to make multiple visits to the pharmacy. PPA is advocating for legislation that would permit this in Pennsylvania. 





Expanding Pharmacist-Provided Immunization Opportunities:

Bill Number: House Bill 91 - Introduced by Rep. Seth Grove (R-196)

Bill Number: Senate Bill 274 - Introduced by Sen. Judy Ward (R-30)



  • House Bill 91 was referred to House Health Committee
  • Senate Bill 274 was referred to the Senator Consumer Protection and Professional Licensure Committee. 


PPA is advocating for a change in Pennsylvania law to permit pharmacists to provide all immunizations to patients nine years of age and older. Click here for more information.



Pharmacy Technician Registration:

Click here to read Rep. Tony DeLuca's Co-Sponsorship Memo.

Bill Number:  House Bill 770 - Introduced by Rep. Tony DeLuca (D-32)



  • Voted out of House Professional Licensure Committee 5-8-19 by a vote of 23-2
  • Referred to the House Professional Licensure Committee 3-11-19


Pennsylvania is one of only five states that does not register or in some way regulate pharmacy technicians. PPA is supporting legislation that would provide for a basic registration along with a criminal history background check and a few other requirements. Click here for more information.




Other Priorities

  • Public Health Emergency: PPA is advocating to allow pharmacists to assist (i.e. allow pharmacists to immunize if there is a shortage before school begins, a virus outbreak, etc.) when the Pennsylvania Secretary of Health declares a public health emergency.


  • CVS-AETNA MERGER:  PPA asks Judge Richard J. Leon to rule against the merger when he extends the deadline for comments. 
  1. PPA letter to Senior Judge Richard J. Leon
  2. Dr. Daniel A. Hussar letter to Senior Judge Richard J. Leon
  3. PARD letter to Senior Judge Richard J. Leon
  4. Pharmacists United for Truth and Transparency (PUTT) letter to Senior Judge Richard J. Leon


Other Bills PPA is Tracking

PPA is monitoring numerous other pieces of legislation. Click here for a full report of all the bills PPA is currently monitoring.




Pennsylvania Community Pharmacy Caucus

The Pennsylvania Community Pharmacy Caucus is a bipartisan, alliance of legislators from both the House and Senate, who advocate for and support community pharmacy throughout the Commonwealth. Working together, caucus members reinforce the important role pharmacists play as healthcare providers and as part of an interdisciplinary team of care. Click here to learn more.



Recap of the 2017-2018 Legislative Session

  • HB 270 - Medication Synchronization in PACE and PACENET.  Passed the House and Senate and Signed into law by Governor Wolf.  Known as Act 87 of 2018
  • HB 2212 - Unfair Pharmacy Reimbursement - Passed the House unanimously.
  • HB 2211 - Prohibition of Gag Clauses - Passed the House unanimously.


Recap of the 2015-2016 Legislative Session


BIG LEGISLATIVE WINS! In the 2015-2016 legislative session, PPA helped pass legislation that:

  • Requires PBMs to register in PA
  • Increases MAC and generic pricing transparency
  • Establishes uniform audit standards
  • Increases the PACE professional dispensing fee to $13
  • Expands drug take-back locations
  • Improves the PDMP for pharmacists
  • Allows for substitution of interchangeable biological products

Click here for a summary and list of resources for Act 169 of 2016.


Click here for a full summary of PPA's 2015-2016 legislative successes.



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