Video & Transcript DataContr Research : 'PBMs'

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TX
Transcript Highlights:
  • The PBMs are currently regulated by the PBMs right now, and that has not been borne.
  • Variants of the PBMs are currently regulated by the PBMs right now, and that has not been proven to be
  • So, adding ERISA-based PBMs under...
  • They have PBMs, and they have plans.
  • prevents a PBM from steering patients to the pharmacy it owns, or the provision that prohibits a PBM
Summary: The meeting involved in-depth discussions focused primarily on several significant bills aimed at reforming healthcare, improving consumer protection, and enhancing community-based care. Key highlights included House Bill 1919 and House Bill 1763, which address the roles and regulation of pharmacy benefit managers (PBMs) in Texas. Lawmakers emphasized the need for these bills to create a fairer landscape for independent pharmacies while ensuring patient access to necessary medications. Public testimonies reflected both support for the reforms and concerns regarding their potential implications. Another major topic was Senate Bill 513, which proposes the development of a pilot program for community-based care in rural West Texas, aiming to improve child welfare services in regions facing unique challenges.
TX
Transcript Highlights:
  • Will this impact PBM profits?
  • That was how much the PBM paid its own pharmacy to dispense the...
  • A PBM is...
  • and then actually a PBM being excessive...
  • But there are problems with PBMs, and the PBM is embedded inside an...
Summary: The meeting of the committee witnessed significant discussions surrounding several Senate Bills aimed at healthcare and child welfare. Notably, Senate Bill 916, presented by multiple representatives, garnered positive testimonials from various stakeholders including emergency medical service leaders who emphasized the bill's potential to promote transparent billing practices, thereby reducing the financial burden on patients. The committee also heard extensive testimony supporting Senate Bill 1122, which aims to regulate pharmacy benefit managers to ensure that cancer patients are not forced into medication access issues. Stakeholders argued for and against the bill, suggesting that it may raise healthcare costs for Texas businesses in the long run, eliciting a vigorous debate.
TX

Texas 2025 - 89th Regular

Insurance Apr 9th, 2025 at 10:30 am

House Insurance Committee

Transcript Highlights:
  • We're talking about the PBM.
  • He owns the PBM.
  • I'm not saying a vertical PBM, but they've got a PBM that they work with, they gave him the...
  • , the PBM is skimming...
  • They all have integrated PBMs, right?
Summary: The House Committee on Insurance convened to discuss multiple bills aimed at enhancing consumer protection and improving access to essential services. Notable discussions included HB2528, which seeks to eliminate prior authorization requirements for medications treating substance use disorders, thereby expediting access to crucial treatments for Texans. Representative Boosie laid out HB722, addressing transparency in auto insurance valuation processes, prompting engagement from various witnesses on how current practices potentially exploit consumers. Members voiced concerns about the intersection of bureaucratic delays and the urgency of addiction treatment, emphasizing the bill's potential life-saving implications.
TX

Texas 2025 - 89th Regular

Health and Human Services Apr 1st, 2025

Senate Health & Human Services Committee

Transcript Highlights:
  • It will require PBMs to have contracts readily available on an online portal or map.
  • PBMs and the pharmacy would have to agree to the modifications.
  • The amount paid by the PBM for the claim for the actual medication was over $2,800.
  • directly with the health plan or PBM.
  • I remember what the spending was supposed to be on PBMs.
Summary: The meeting centered on multiple significant legislative proposals aimed at healthcare reforms, notably focused on the operations of pharmacy benefit managers (PBMs) and their impact on local pharmacies. Senator Hughes led the discussion on SB1236, which aims to regulate PBMs to prevent anti-competitive practices that have led to the closure of numerous community pharmacies. Testimonies from various stakeholders, including pharmacists, highlighted the challenges posed by current PBM practices, such as aggressive audit tactics and contract terms that disadvantage small pharmacies. The bill was generally supported in the committee due to its potential to restore balance and fairness in pharmacy operations.
TX

Texas 2025 - 89th Regular

Insurance Apr 17th, 2025 at 10:04 am

House Insurance Committee

Transcript Highlights:
  • The Big Three PBMs control over 80% of the market for prescription drug reimbursements in the country
  • A recent FTC report found this inherent conflict of interest led to PBMs overpayment...
  • It would also require PBMs and health plans to use

  • It also has a subsection directing PBMs to include provider manuals in the.
  • However, the PBM uses small clerical errors to claw back that full amount.
Summary: The meeting was characterized by detailed discussions surrounding several key bills, including HB1464, HB4012, and SB916. Representative Tallarico provided an overview of HB1464, which establishes a state drug purchasing pool aimed at reducing prescription costs for Texas consumers. Multiple stakeholders offered testimony, emphasizing the potential savings and expressing support for the bill. On the other hand, the discussion around HB4012 elicited differing opinions, particularly related to its implications for fraud enforcement in private insurance, with opponents warning against government overreach in private business dealings. Senator Spillers presented SB916, focusing on consumer protections against surprise billing from emergency medical services, indicating collaborative efforts with various health plans to strengthen patient protections without imposing financial burdens on them. Throughout the meeting, representatives and witnesses engaged in constructive dialogue about healthcare costs, insurance reforms, and consumer protection measures. The committee concluded with several bills left pending for future consideration, indicating ongoing concerns and a commitment to further deliberation on these important legislative matters.
US
Transcript Highlights:
  • data-time="1296"> We want to commit the FTC to finish the work that has started in studying the impact of PBMs
  • The PBM industry and collecting data will shore up marketplace transparency and help us address concerns
  • about abusive PBMs.
  • But they try to accomplish the same goal of making PBMs'
Summary: The meeting focused on addressing the high cost of prescription drugs and the abusive practices that contribute to elevated prices affecting American families. Several bills were presented, including proposals to end pay-for-delay deals and to enhance transparency in the operations of pharmacy benefit managers (PBMs). The discussion was notable for its emphasis on consumer protection and ensuring that cheaper generic drugs reach the market more effectively. Members expressed frustration over past attempts to pass similar legislation stalling in the Senate, leading to renewed efforts to push these bills forward.
TX

Texas 2025 - 89th Regular

Delivery of Government Efficiency Mar 26th, 2025 at 10:30 am

House Delivery of Government Efficiency Committee

Transcript Highlights:
  • How do you handle the use of your PBM with those contracts, if I may ask?
  • your in-house PBM or others, but...
  • From the PBM? Yes.
  • I asked about PBMs, right?
  • We have contracts with a PBM, an independent PBM.

Summary: The meeting of the committee involved detailed discussions surrounding several key pieces of legislation, most notably focused on the implications of artificial intelligence through HB149. This bill was presented by Chairman Capriglione as a comprehensive framework aimed at addressing potential harms associated with AI usage in Texas, emphasizing consumer protection and accountability. Witnesses from various organizations provided input, highlighting the bill's aim to create clarity around acceptable AI practices while simultaneously fostering innovation. Some members raised concerns over specific provisions related to political viewpoint discrimination and local preemption, indicating a need for adjustments to ensure comprehensive protections without infringing on existing rights.
TX

Texas 2025 - 89th Regular

Health and Human Services Mar 18th, 2025

Senate Health & Human Services Committee

Transcript Highlights:
  • When the PBM...
  • ...the PBM to design our prescription drug system.
  • As a contract with a PBM, I would assume.
  • So PBMs are not supposed to be able to retaliate; that doesn't mean that they might not, but there is
  • If PBMs get wind that this cash pricing is going to be a
Summary: The meeting of the committee was focused predominantly on various bills concerning healthcare and insurance policies, reflecting significant discussions on how these laws impact the community. Notably, Senate Bill 660 was introduced to enhance safety measures at healthcare facilities, discussing the necessity for bollards to prevent unauthorized vehicular access, highlighting a bipartisan understanding of public safety. Senator West emphasized the importance of these regulations, citing real-world incidents that necessitate such actions. Public testimonies complimented this discussion, providing insight into community needs for enhanced security in hospitals.
US
Transcript Highlights:
  • They could have come to this committee and said they supported the PBM efforts to lower drug costs, and
  • People are going to have to mail it in because a PBM makes more money to be able to do that.
  • ...on the issue of PBMs and thoughts that you may have on
  • rebates are actually fully rebating the monies that's being saved by the negotiations done by the PBMs
  • One of the areas the PBMs have been particularly bad

Summary: The committee convened to discuss critical issues surrounding the nomination of Michael Falkender for the position of Deputy Secretary of the Treasury. This meeting included a series of remarks from committee members who expressed divergent views on Falkender's qualifications and the implications of his appointment. Senator Wyden voiced strong opposition, arguing that Falkender represents harmful policies expected to be perpetuated under the current administration, especially concerning taxpayer privacy and IRS tactics. Meanwhile, other members defended Falkender, noting his extensive experience, including a commitment to transparency in government operations if confirmed.
TX

Texas 2025 - 89th Regular

Insurance Apr 30th, 2025 at 08:04 am

House Insurance Committee

Transcript Highlights:
  • It's because they're not affordable due to the way the PBMs are processing them.
  • prescription drug coverage is made to pay more than someone without insurance simply because of the PBM
  • reason a patient should be incentivized to pay more for prescription drugs, but that's exactly how the PBMs
  • This bill is a step towards restoring trust, reining in harmful PBM
Summary: The meeting of the House Committee on Insurance focused on several significant bills, including HB854, which aims to reform insurance payment structures to improve accessibility for homeowners needing urgent repairs. Representative Garcia-Hernandez strongly advocated for this bill, highlighting the struggles faced by constituents unable to cover upfront repair costs. Additionally, HB4092 was discussed, which seeks to clarify regulations surrounding pre-suit notices in insurance claims, emphasizing the importance of protecting policyholders' rights. The meeting included various testimonies, with both supporters and opponents voicing their concerns about how these bills could impact consumers and the insurance industry.
US
Transcript Highlights:
  • for farmers and consumers, and the litigation against PBMs
Summary: The meeting of the Senate Committee on Commerce, Science, and Transportation featured significant discussions regarding technological advancements and their implications for the future. Notably, nominations were made for key positions in the White House's Office of Science and Technology Policy and the Federal Trade Commission. Committee members expressed the importance of leading in emerging technologies like artificial intelligence and quantum computing, emphasizing that the pace of innovation is crucial for maintaining the United States' global position as a leader in technology. The discussions also highlighted the role of the FTC in protecting consumers from deceptive business practices and ensuring fair competition in the marketplace. Attendees underscored the urgency of advancing research and development in areas such as quantum computing, as evidenced by a demonstration of a new quantum chip anticipated to redefine computing capabilities across industries. Various members engaged in vibrant exchanges, showing support for initiatives aimed at bolstering innovation through public and private collaboration. Overall, the meeting set a strong agenda for pursuing future science and technology policies that ensure the U.S. remains at the forefront of global advancements.
US
Transcript Highlights:
  • Oz's willingness to consider some interesting and important reforms like PBMs or the basic health plan
  • Oz's willingness to consider some interesting and important reforms like PBMs or the basic health plan
  • Oz's willingness to consider some interesting and important reforms like PBMs or the basic health plan
Summary: The committee meeting focused heavily on the nomination of Frank Bisignano as the Commissioner of the Social Security Administration, with intense discussions around the current state of Social Security and its management under the current administration. Members voiced significant concerns regarding potential changes to Social Security and Medicaid, specifically addressing issues such as office closures, delays in benefit processing, and the perceived policies from Elon Musk's association with the administration. Public testimonies highlighted fears that these changes would severely impact the accessibility of benefits for seniors and vulnerable individuals, resulting in a chaotic environment at the SSA. Members expressed a unified opposition to the notion of dismantling these critical programs, emphasizing the long-term implications on their constituents' well-being.
TX

Texas 2025 - 89th Regular

Insurance Apr 23rd, 2025 at 08:04 am

House Insurance Committee

Transcript Highlights:
  • CSHB 3233 prohibits PBMs, Pharmacy Benefit Managers, from
  • PBM clients like to have choices when storing their data, and so having the flexibility as this bill
Summary: The House Committee on Insurance meeting covered multiple bills focused on healthcare regulations and patient accessibility. Notably, House Bill 3057 was highlighted in testimony from citizens advocating for expanded access to CAR T-cell therapy, which has shown effectiveness for blood cancers. Testimonies were given by affected individuals, emphasizing the need for local treatment options without the burden of travel to distant medical facilities. Similarly, House Bill 4603 was laid out with the intent to align arbitration options and ensure that consumers receive timely resolutions in disputed medical charges. Overall, the committee demonstrated an active engagement with the public and various stakeholders while navigating key issues affecting health insurance and patient care in Texas.
TX

Texas 2025 - 89th Regular

Finance (Part II) Jan 28th, 2025

Transcript Highlights:
  • Does Correctional Managed Health Care have what they call a PBM?
  • Do they have inside of themselves a PBM?
  • Does Correctional Managed Health Care have what they call a PBM?
  • Do they have inside of themselves a PBM?
  • Do they have inside of themselves a PBM?
Summary: The meeting of the committee centered around discussions on the budgets for the Texas Department of Public Safety and the Texas Juvenile Justice Department. Significant recommendations included a proposed budget of $3.7 billion for the Department of Public Safety, which reflects a decrease of $199.6 million from the previous cycle. Key topics included customer service enhancements and the increase of staff to improve operations and reduce wait times. Additionally, the Juvenile Justice Department's funding was discussed, including adjustments related to staff salary increases and facility needs.
TX

Texas 2025 - 89th Regular

89th Legislative Session May 12th, 2025 at 10:05 am

Texas House Floor Meeting

Transcript Highlights:
  • This is the PBM Patient Data Bill. I move passage.
  • I think I've discussed this with Chairman Harris as well, to really study the PBM market and see ways
  • " data-time="8604">Have you ever had the opportunity to look at some of the videos that explain how PBM
  • Have you... you know, we started PBMs in an effort to be a cost-saving measure.
  • how they repackage and sell drugs, if you've never seen the scams that they've pulled, we created PBMs
Bills: HB46, HJR35, HJR47, HJR182, HB113, HB983, HB4847, HB1449, HB3833, HB5151, HB265, HB1845, HB782, HB108, HB1960, HB158, HB1954, HB1955, HB2512, HB605, HB2581, HB2803, HB627, HB2667, HB1738, HB636, HB3679, HB2638, HB2655, HB871, HB2438, HB1107, HB1765, HB1822, HB2153, HB4099, HB3732, HB3171, HB3178, HB3182, HB3749, HB2814, HB3977, HB4204, HB4207, HB4449, HB1820, HB1876, HB1939, HB1347, HB2593, HB2136, HB2132, HB2658, HB2413, HB2757, HB2080, HB3154, HB3063, HB3009, HB3448, HB3006, HB2844, HB3241, HB3680, HB3169, HB2078, HB2507, HB4559, HB3946, HB3460, HB3405, HB475, HB3463, HB3441, HB3520, HB2060, HB4731, HB4991, HB1991, HB5596, HB2014, HB2142, HB2673, HB2731, HB2417, HB2399, HB2301, HB3335, HB3234, HB3320, HB5573, HB4848, HB4748, HB4769, HB4795, HB2086, HB2234, HB2203, HB4916, HB5624, HB4505, HB139, HB5093, HB5302, HB5402, HB5606, HB2333, HB4630, HB4701, HB2583, HB2983, HB4924, HB3339, HB3793, HB3631, HB4882, HB5509, HB5499, HB5430, HB5561, HB5611, HB5043, HB5064, HB3733, HB3781, HB3219, HB32, HB4515, HB5348, HR559, HB4506, HB1646, HB3185, HB3388, HB2761, HB3233, HB1534, HB5129, HB5394, HB3619, HB2867, HB3672, HB2434, HB4903, HB3687, HB3675, HB4609, HB4582, HB3866, HB4534, HB2446, HB3984, HB700, HB4088, HB229, SB2419, SB842, SB1257, SB2550, SB996, HB1186, HB4327, HB3221, HB2588, SB552, HB4870, HB2494, HB3940, HB4838, HB3177, HB1441, SB1841, HB3962, HB2225, HJR112, HB897, HB2695, HB4670, HB3602, HB3317, HB3717, HB3138, HB3704, HB1403, HJR218, HB4921, SJR37, HJR138, HJR144, HB3892, HB4, HB46, HJR35, HJR47, HJR182, HB4234, HB722, HB4136, HB4105, HB4413, HB170, HB551, HB2858, HB3053, HB3142, HB3180, HB3722, HB2200, HB1794, HB1784, HB1581, HB2530, HB4308, HB1896, HB2974, HB3359, HB4580, HB2458, HB2215, HB3332, HB2278, HB3015, HB3151, HB1368, HB40, HB101, HB112, HB146, HB168, HB214, HB413, HB1523, HB493, HB521, HB594, HB557, HB305, HB549, HB854, HB1057, HB1052, HB842, HB3174, HB3311, HB2486, HB3196, HB824, HB1039, HB2529, HB2713, HB4936, HB4995, HB4830, HB4864, HB5219, HB5263, HB5154, HB2674, HB5525, HB5623, HB2545, HB2587, HB2625, HB5520, HB5436, HB4926, HB1573, HB5165, HB4811, HB5081, HB4755, HB3179, HB4310, HB4611, HB2159, HB4626, HB3637, HB3153, HB3066, HB2786, HB2966, HB638, HB640, HB876, HB497, HB5539, HB4809, HB5308, HB4687, HB4070, HB4421, HB4412, HB3284, HB3369, HB3420, HB3449, HB4098, HB4281, HB4120, HB4504, HB4370, HB1106, HB2370, HB2404, HB3863, HB2407, HB2253, HB2273, HB2040, HB1586, HB3788, HB3993, HB4690, HB4309, HB4696, HB2308, HB1142, HB1533, HB1621, HB2242, HB2012, HB2193, HB2442, HB2464, HB2348, HB2313, HB2289, HB1942, HB2011, HB1629, HB2993, HB3592, HB3824, HB4076, HB4535, HB4623, HB4773, HB1091, HB5115, HB5515, HB3372, HB5659, HB127, HB386, HB115, HB2868, HB1249, HB4766, HB3720, HB4656, HB4879, HB105, HB5383, HB4621, HB5431, HB5678, HB5534, HB4174, HB4212, HB3954, HB3966, HB3636, HB3918, HB1422, HB4765, HB4732, HB4742, HB5122, HB4518, HB5084, HB3986, HB4045, HB4144, HB3911, HB3976, HB4473, HB3425, HB3641, HB3642, HB3475, HB3509, HB3424, HB3383, HB4744, HB4531, HB4539, HB3159, HB5228, HB5370, HB4359, HB4398, HB4443, HB4466, HB3861, HB3849, HB4240, HB4706, HB4685, HB5354, HB5141, HB5686, HB3629, HB3554, HB3567, HB2015, HB3575, HB5381, HB1431, HB3514, HB4614, HB4546, HB4683, HB5681, HB5673, HB5663, HB4271, HB4350, HB4035, HB3807, HB3812, HB3552, HB3540, HB3715, HB3710, HB3664, HB4196, HB4233, HB4173, HB1998, HB3333, HB3510, HB4222, HB2070, HB2854, HB2347, HB113, HB983, HB4847, HB1449, HB3833, HB5151, HB265, HB1845, HB782, HB108, HB1960, HB158, HB1954, HB1955, HB2512, HB605, HB2581, HB2803, HB627, HB2667, HB1738, HB636, HB3679, HB2638, HB2655, HB871, HB2438, HB1107, HB1765, HB1822, HB2153, HB4099, HB3732, HB3171, HB3178, HB3182, HB3749, HB2814, HB3977, HB4204, HB4207, HB4449, HB1820, HB1876, HB1939, HB1347, HB2593, HB2136, HB2132, HB2658, HB2413, HB2757, HB2080, HB3154, HB3063, HB3009, HB3448, HB3006, HB2844, HB3241, HB3680, HB3169, HB2078, HB2507, HB4559, HB3946, HB3460, HB3405, HB475, HB3463, HB3441, HB3520, HB2060, HB4731, HB4991, HB1991, HB5596, HB2014, HB2142, HB2673, HB2731, HB2417, HB2399, HB2301, HB3335, HB3234, HB3320, HB5573, HB4848, HB4748, HB4769, HB4795, HB2086, HB2234, HB2203, HB4916, HB5624, HB4505, HB139, HB5093, HB5302, HB5402, HB5606, HB2333, HB4630, HB4701, HB2583, HB2983, HB4924, HB3339, HB3793, HB3631, HB4882, HB5509, HB5499, HB5430, HB5561, HB5611, HB5043, HB5064, HB3733, HB3781, HB3219, HB32, HB4515, HB5348, HCR76, HCR127, HCR9, HCR40, HCR118, HR559
Summary: The meeting featured extensive discussions on various bills, focusing primarily on HB5623, SB1278, and legislative initiatives relating to healthcare and education reforms. A notable topic was the passage of HB594, which aimed to increase the number of positions exempt from civil service in certain counties, underscoring the need for more flexible leadership in law enforcement. This bill stirred conversations around accountability and resource allocation, emphasizing the balancing act between public service and administrative efficiency. Another significant point of discussion was the feedback from community members and various stakeholders, who expressed their views on education policies under consideration. Overall, the meeting was characterized by a collaborative atmosphere with multiple voices contributing to the dialogue about the future legislative direction in these critical areas.
TX

Texas 2025 - 89th Regular

Health and Human Services Apr 30th, 2025

Senate Health & Human Services Committee

Transcript Highlights:
  • For example, we've talked about PBMs and outsourcing, right?
  • Not owning your PBM or contracting that out.
Summary: The meeting of the Senate Committee on Health and Human Services covered multiple bills focusing on healthcare, education, and child welfare. A key highlight was the presentation of Senate Bill 3001, which aims to add medical nutrition counseling as a Medicaid service for patients with chronic conditions. Chairman Korkhorst emphasized the importance of this bill in addressing healthcare needs in low-income communities. Public testimony was gathered, with several professionals supporting the inclusion of nutrition services to improve health outcomes for Texans, particularly those battling chronic diseases. Another notable discussion revolved around Senate Bill 425, designed to enhance the accuracy of investigations into child and adult protective services. Members raised concerns regarding the need for transparency and improved protocols in these sensitive areas.
TX

Texas 2025 - 89th Regular

Health and Human Services Apr 2nd, 2025

Senate Health & Human Services Committee

Transcript Highlights:
  • That's the only way we're going to begin I've heard PBM bills
Summary: The Senate Committee on Health and Human Services convened to discuss several significant bills, including SB968, SB966, and SB437. Senator Zaffirini presented SB968, which aims to modernize podiatry regulations in alignment with current practices, while SB966 involves the licensing and regulation of podiatry, addressing outdated provisions following a 2017 transition to the Texas Department of Licensing and Regulation. Both bills indicate a necessary clean-up of statutory language to better reflect contemporary standards in healthcare regulations. Additionally, Senator Hinojosa proposed SB437, which focuses on providing effective regulatory frameworks for chemical dependency treatment facilities, highlighting an urgent increase in demand due to rising substance abuse rates post-COVID-19.
TX

Texas 2025 - 89th Regular

Insurance Mar 26th, 2025 at 10:30 am

House Insurance Committee

Transcript Highlights:
  • Paired with a PBM, like we want all PBMs to work, to pass
Summary: The committee meeting revolved around key discussions on several proposed bills, particularly focusing on HB3211, which aims to improve patient access to optometrists. Multiple stakeholders participated, expressing their views and concerns regarding the impact of the bill on vision care networks. The discussions highlighted the need for a clearer application process for optometrists to be included in vision plan networks, reflecting a powerful sentiment from both healthcare professionals and patients about access to care. The meeting also encapsulated varying perspectives on the legal aspects surrounding HB2275, addressing arbitration provisions for surplus policies, illustrating the committee's diligence in scrutinizing regulatory frameworks for consumers.
TX

Texas 2025 - 89th Regular

Health and Human Services (Part II) Apr 23rd, 2025

Senate Health & Human Services Committee

Transcript Highlights:
  • So is it a PBM?
Summary: During this meeting of the Senate Committee on Health and Human Services, significant attention was given to various bills aimed at enhancing healthcare provisions and improving processes within the health sector. Notable discussions included the presentation of Senate Bill 547 by Senator Menendez, which seeks to streamline provider notice requirements for healthcare professionals by proposing a centralized database managed by the Texas Department of Insurance. The bill was favorably reported and moved forward with recommendations for local and uncontested calendars. Additionally, a committee substitute for Senate Bill 2308 was introduced, focusing on innovative mental health treatments for veterans, particularly regarding ibogaine as a treatment for opioid use disorder. This proposal received strong support due to its potential to lead the nation in mental health care advancements.

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