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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

 

Local Lawmaker Looks For More Transparency From Pharmacy Benefit Managers

 

 

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

 

 

LEGISLATION

 

PBM Transparency and Fair Reimbursement in Medicaid Package (HB 941, HB 942, HB 943, HB 944) passed the House Health Committee unanimously on June 11.   HB 945 was introduced on 6/18/19. 

 

Click here for the Issue Brief

 

 

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

 

Fair Reimbursement: HB 941

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

Bill number 941 - Introduced by Rep. Doyle Heffley (R-122) and Rob Matzie (D-16)

Status -  Passed House Health Committee on 6-11-19

 

Senate Fair Reimbursement: SB 

Click here to read Sen. Judy Ward's co-sponsorship memo.

 

Pharmacy & Therapeutics Committee: HB 942

Click here to read Rep. Seth Grove's co-sponsorship memo.

Bill number 942 Introduced by Rep. Seth Grove (R-196)

Status - Passed House Health Committee on 6-11-18

Background - This bill adds 2 community pharmacists to the Medicaid P&T committee. 

 

Prohibition of Gag Clauses to elected officials: HB 943

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

Bill Number 943 - Introduced by Rep. Valerie Gaydos (R-44)

Status - Passed House Health Committee on 6-11-19

Background - Would allow the pharmacist to discuss price and alternatives with patients and allow disclosure of information to elected officials and the Department of Human Services, upon request. 

 

Senate Expanded Prohibition of Gag Clauses: SB 639

Click here to read Rep. Kristen Phillips-Hill's co-sponsorship memo.

Bill Number SB 639 - Introduced by Sen Kristen Phillips-Hill

Status - Referred to the Senate Banking and Insurance Committee May 13, 2019

 

Authority to Audit Subcontracts with Pharmacy Benefit Managers: HB 944

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

Bill Number 944 - Introduced by Rep. Jonathan Fritz (R-111)

Status - Passed House Health Committee on 6-11-19

Background - Provides that the Auditor General can audit PBM contracts. 

 

Senate Authority to Audit Subcontracts with Pharmacy Benefit Managers: SB

Click hereto read Sen. Ryan Aument's co-sponsorship memo

Bill Number - Introduced by Sen. Ryan Aument

Status

 

 

Conflict of Interest: HB 945

Click here to read Rep. Stephen Barrar's co-sponsorship memo

Bill Number 945 - Introduced by Rep. Stephen Barrar (R-160)

StatusIntroduced on 6-18-19

Background - This bill would prevent an MCO from contracting with a PBM that has an ownership interest in a pharmacy or a pharmacy that has an ownership interest with a PBM or a corporate affiliate of the PBM.  This legislation also provides that a PBM may not require that patient use the services of a specific pharmacy for specialty drugs. 

 

Senate Conflict of Interest: SB 

Click here to read Sen. Dave Argall's co-sponsorship memo

Bill Number

Status

 

 

Other Legislation

 

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 hereto read Rep. Tony DeLuca’s co-sponsorship memo.  

Bill Number: House Bill 570

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

Background

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.

 

 

Medication Synchronization:

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

Issue Brief

Status

  • Passed the Senate Banking and Insurance Committee 6-10-19
  • HB 195 passed the House unanimously on 2/4/19. 

Background

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)

Issue Brief

 

Status

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

Background

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)

 

Status

  • Passed the House on 5-15-19 by a vote of 163-25 - Currently in the Senate Consumer Protection and Professional Licensure Committee. 
  • 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

Background

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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