Lawmakers consider bill regulating pharmacy benefit managers

Capitol Bureau

TOPEKA, Kan. (KSNW) – Lawmakers are considering a bill that may change the way Kansans receive their prescriptions.

Pharmacy benefit managers (PBMs) are third party organizations who contract with insurance companies to help negotiate to provide patients with medications from pharmacies. Some of the largest PBMs include OptumRX (partners with UnitedHealth Group), CVS/Caremark (CVS Health), and Express Scripts (Cigna Corporation).

HB2598 would require PBMs to disclose their operating information to the Kansas Insurance Department, such as quarterly data reports. It would also require these companies to receive licenses and to send an explanation of benefits to their customers.

“We want transparency in the marketplace. We want them to have to disclose to the people that they sign contracts with how they practice, how they effectively make their money,” said Matt Morrison, President of the Kansas Pharmacists Association, who proposed the bill.

Dan Sutherland, owner of St. Mary’s Pharmacy, says that PMBs have sent the number of prescriptions he fills down every year.

This is because PMBs contract with insurances to send people to the pharmacies they own, Sutherland said.

Many locally-owned pharmacies have closed due to this, making it more difficult for new graduates to find jobs, Morrison said.

“Statistically, independent, locally-owned pharmacies provide the best service,” Morrison said. “Lower wait times, better service, they get a face-to-face with a pharmacist when they walk in. They’re better equipped to provide medical care across the board, including specialty care.”

The bill passed out of the House Committee on Insurance on Feb. 19, and is now awaiting a hearing on the House floor.

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