Creates provisions relating to payments for prescription drugs
One of the critical impacts of HB840 is the establishment of restrictions on pharmacy benefits managers (PBMs) relating to how they set reimbursement rates for pharmacies. The bill requires that the reimbursement for pharmacies should not be less than the average acquisition cost of the drug being dispensed. This change is expected to increase the financial viability of independent pharmacies, which often struggle under the weight of low reimbursement rates from PBMs.
House Bill 840 aims to revise existing laws related to the management of prescription drug payments and the responsibilities of pharmacy benefits managers in Missouri. It repeals sections 338.015, 376.387, and 376.388 of the Revised Statutes of Missouri, which previously delineated how pharmacies and pharmacy benefits managers could interact, particularly regarding the reimbursement for prescription drugs. The new provisions introduced through this bill aim to better align the reimbursement processes and protect the rights of pharmacies in negotiating payments.
Notable points of contention surrounding HB840 include the potential pushback from large pharmacy benefits managers who may view these regulatory changes as a threat to their business model. Proponents argue that the bill is essential for ensuring fair pricing and better access to medications for patients. On the other hand, opponents may assert that imposing stricter rules on PBMs could lead to increased costs in health insurance premiums or reduce the variety of drug coverage available to patients due to cost management issues.
The bill also emphasizes the patient's right to receive written prescriptions to take to the facility of their choice, thereby reinforcing patient choice in healthcare services. By ensuring that PBMs do not penalize pharmacies for allowing this choice, HB840 aims to foster a more competitive and patient-centered healthcare environment.