The proposed changes will have a significant impact on state laws governing pharmacy benefits and the practices of PBMs. By enacting SB896, the state aims to promote fairness and transparency in the pharmacy sector. The bill will also address complaints from pharmacists and consumers about the lack of transparency in drug pricing and the restrictive practices of PBMs that can limit patient access to necessary medications. It will help ensure that beneficiaries receive complete and accurate information regarding their prescriptions, including costs and available alternatives.
Summary
Senate Bill 896 aims to regulate the activities of pharmacy benefits managers (PBMs) by prohibiting specific practices that affect pricing and pharmacy participation in contracts. This bill seeks to prevent PBMs from engaging in practices such as spread pricing, which can lead to higher costs for consumers. Additionally, it mandates that PBMs cannot deny any pharmacy the right to participate in their networks if they meet certain conditions. This legislation intends to enhance competition and accessibility in the pharmacy market, ensuring that all pharmacies have a fair opportunity to serve patients.
Contention
One notable point of contention surrounding SB896 has been the balance between regulating PBMs and allowing them to operate efficiently. Proponents argue that without these regulations, PBMs can exploit their bargaining power, leading to increased prices for consumers and reduced access to medications. Opponents, on the other hand, express concern that overly restrictive regulations may impede the ability of PBMs to negotiate lower prices with manufacturers, potentially affecting the overall affordability of drugs. The discussions highlight the need for a balanced approach that safeguards consumer interests while preserving the operational viability of PBMs.
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.