Mississippi House Bill HB987

Mississippi 2023 Regular Session

• Introduced: 1/16/23
• Refer: 1/16/23
• Failed: 1/31/23

Caption

Pharmacy Benefit Prompt Pay Act; revise various provisions of.

Impact

The bill's modifications could significantly impact the financial interactions between pharmacies and pharmacy benefit managers, particularly by establishing reimbursement rates that cannot fall below the national average drug acquisition cost at the time of service, along with a defined professional dispensing fee. Furthermore, it mandates that pharmacy benefit managers develop administrative appeal procedures that allow pharmacies to contest any reimbursement disputes. This approach aims to create a more equitable financial environment for pharmacies and improve patient access to medications.

Summary

House Bill 987 aims to amend various sections of the Mississippi Code related to the Pharmacy Benefit Prompt Pay Act, primarily focusing on ensuring fair reimbursement practices for pharmacies participating in the federal 340B drug discount program. The bill introduces the prohibition of certain discriminatory practices by health insurance issuers and pharmacy benefit managers, thus safeguarding pharmacies involved in providing discounted medications to eligible patients. By defining new terms and amending existing provisions, HB987 seeks to create clearer regulations that govern reimbursement and administrative procedures for pharmacies.

Contention

Notable points of contention surrounding HB987 include concerns over the enforcement and practicality of the outlined regulations. Some stakeholders argue that the bill may create additional burdens for pharmacy benefit managers with its stringent requirements, while proponents emphasize the need for regulation in protecting pharmacies and ensuring patient choice in medication procurement. The conflict predominantly arises from different perspectives on the balance of power within the pharmacy benefit management landscape and the implications of regulatory oversight on operational efficiencies.