Pharmacy Benefit Prompt Pay Act; revise.
The bill also sets forth provisions that mandate PBMs to reimburse pharmacies at no less than the national average drug acquisition cost at the time the drug is administered, in addition to a professional dispensing fee. This change is intended to ensure that pharmacies are fairly compensated for the medications they dispense and that their operational costs are sustainably covered. Furthermore, the legislation requires PBMs to maintain updated pricing information and sets administrative procedures for pharmacies to appeal reimbursement decisions, promoting transparency in financial transactions and practices.
Senate Bill 2894 seeks to enhance the regulations regarding pharmacy benefit managers (PBMs) in Mississippi by amending various sections of the Mississippi Code of 1972. One of the main thrusts of the bill is to define new terms and impose restrictions on PBMs to prevent practices deemed discriminatory, particularly concerning entities participating in the federal 340B drug discount program. By establishing clear rules, this legislation aims to create a more equitable landscape for pharmacies that provide services under this program, ensuring that they are not unfairly treated compared to their non-340B counterparts.
While the bill is welcomed by many in the pharmacy community as a step towards greater fairness in drug pricing and reimbursement, it may prompt discussions regarding the implications for PBMs' operational flexibility. Supporters argue that it protects pharmacies and ensures patient access to medications without undue burden, while opponents might contend that the enhanced regulations could impose additional costs on PBMs, which could ultimately affect pharmacy benefit structures and drug pricing strategies. The balance to be struck is essential in the broader context of healthcare affordability and access.
Notably, the bill prohibits PBMs from requiring patients to use specific affiliated pharmacies and protects pharmacists and pharmacy employees from retaliation for asserting rights granted under this act. These provisions are crucial in safeguarding patient choice and ensuring that pharmacies can provide their services without external pressures. Furthermore, the State Board of Pharmacy is empowered to enforce these regulations and impose penalties on non-compliant organizations, enhancing the enforcement mechanisms available under the law.