Georgians with Intellectual and Developmental Disabilities Innovation Commission; create
The implementation of SB198 will result in significant changes to how reimbursement is handled for pharmacies participating in the state health benefit plan. By mandating that independent pharmacies receive equal reimbursement rates to those of larger chain pharmacies, the bill is designed to strengthen the financial stability of independent pharmacies and enhance their ability to serve the community. This legislative change is viewed as a step toward balancing the competitive disparities that exist between independent and chain pharmacies, potentially fostering more favorable conditions for small business pharmacies operating within the state.
Senate Bill 198 aims to amend the Official Code of Georgia Annotated concerning the reimbursement methodologies employed by pharmacy benefits managers (PBMs) specifically in relation to the state health benefit plan for school teachers, school employees, and state employees. The bill establishes requirements that PBMs must follow when reimbursing independent pharmacies for drugs that are dispensed for self-administration, ensuring that these pharmacies receive no less than the average reimbursement provided to chain retail pharmacies for the same drugs. This effort seeks to enhance equity in reimbursement practices within the pharmacy sector in Georgia.
The sentiment surrounding SB198 appears to be largely positive, particularly among supporters who advocate for independent pharmacies. Proponents of the bill believe that it is a necessary intervention to protect these smaller entities from potential underpayment and to ensure fair compensation for the services they provide. However, there may be some concern regarding how PBMs will adapt to these new requirements and whether they will create unintended consequences for smaller pharmacies, such as reduced access to certain drugs or services.
A notable point of contention surrounding SB198 is the potential administrative burden it may impose on pharmacy benefits managers in terms of compliance and record-keeping. The bill requires annual certification from PBMs to ensure adherence to the new reimbursement standards, as well as the availability of records for audits by the Department of Community Health. Critics of the bill may argue that such requirements could lead to an increase in operational costs for PBMs, possibly affecting their engagement with independent pharmacies and the overall dynamics within the pharmacy market in Georgia.