Authorizes a pharmacist to decline to dispense a covered prescription drug if the coverage provider reimburses the pharmacy in an amount less than the drug's acquisition cost
Impact
The bill modifies Louisiana state law regarding pharmacies by emphasizing fair reimbursement from pharmacy benefit managers (PBMs). By mandating that pharmacies cannot be compensated less than the amount provided to affiliated PBMs for the same services, this legislation aims to ensure that community pharmacies can sustain their operations morally and economically. The implications extend to protecting pharmacists from retaliation or breach of contract claims if they opt to reject a service that is not financially viable.
Summary
House Bill 433 focuses on the operations and business practices related to pharmacies and pharmacy benefit managers in Louisiana. The bill allows pharmacists to decline providing covered drugs or services if the reimbursement rate from pharmacists is lower than the acquisition cost of the drugs or services. This is a critical change meant to protect pharmacists from being forced to operate at a loss when providing necessary medications or services to their customers, reinforcing their ability to make informed financial decisions while serving their clientele.
Sentiment
Discussions surrounding HB 433 appear to be largely positive among supporters, including many pharmacists and legislators who argue that it empowers small pharmacies and enhances consumer protection. The sentiment reflects a favorable view towards creating a balanced and equitable market for pharmaceuticals. However, concerns about adherence to regulatory frameworks and the potential ramifications for pharmacy benefit managers paint a more cautious narrative among critics who may fear increased operational costs.
Contention
Notable points of contention stem from the interactions between PBMs and pharmacies. While supporters contend that this bill fortifies the position of local pharmacies against potentially predatory practices by larger PBMs, opponents raise questions about how this could lead to an increase in prescription costs or limit the availability of certain drugs. The balance between ensuring fair business practices and maintaining a healthy competitive environment in the pharmacy sector remains a debated aspect of the bill.
Relating to pharmacists; to amend Section 27-45A-7, Code of Alabama 1975; to authorize a pharmacist to decline to fill a prescription if the pharmacist will be reimbursed for the drug in an amount that is less than the pharmacist's acquisition cost; and to prohibit a pharmacist from being restricted from discussing matters relating to a pharmacy claim with a patient.
Relating to pharmacists; to amend Section 27-45A-7, Code of Alabama 1975; to authorize a pharmacist to decline to fill a prescription if the pharmacist will be reimbursed for the drug in an amount that is less than the pharmacist's acquisition cost; and to prohibit a pharmacist from being restricted from discussing matters relating to a pharmacy claim with a patient.
Prohibiting network exclusion for pharmacies that refuse to dispense a prescription of the PBM reimbursement that is below the pharmacy's acquisition cost.
Authorizes pharmacists to dispense HIV prophylaxis without individual prescription under certain circumstances; mandates prescription benefits coverage.
Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)
Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)
Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)
Regulation of pharmacy benefit managers, fiduciary and disclosure requirements on pharmacy benefit managers, and application of prescription drug payments to health insurance cost-sharing requirements. (FE)