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NCPA: SFC PBM reform package looking promising

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ALEXANDRIA, Va.  – The Senate Finance Committee has released a new package of legislation that includes additional policies to reform pharmacy benefit managers, a longstanding priority of the National Community Pharmacists Association. The committee, which is led by Chairman Ron Wyden (D-Ore.) and Ranking Member Mike Crapo (R-Idaho), plans to vote Nov. 8 on the proposal.

The new package includes provisions requiring the Centers for Medicare & Medicaid Services to define contract terms and conditions that are “reasonable and relevant” under Medicare Part D and force PBMs to comply while creating a process for pharmacies to report problematic contract terms or potential violations, which is a positive step. NCPA also appreciates that Congress sees the need to propose new solutions to protect patient access to essential pharmacies in underserved areas, which we are still reviewing.

“PBM reforms are essential before it’s too late – not only for independent pharmacies, but also the patients who rely on them,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA. “Congress has a lot of important work to do, but providing relief from PBM-insurer practices will benefit millions of patients and must not get punted. NCPA is grateful to Sens. Wyden and Crapo and the Finance Committee for continuing to push on this and are eager to help these changes get across the finish line.”

NOTE: This package differs from the Modernizing and Ensuring PBM Accountability Act (S. 2973), which passed the Senate Finance Committee in July. MEPA includes additional NCPA-supported PBM reform provisions that would enhance transparency into PBM-insurer operations in Medicaid managed care and delink PBM compensation from the cost of medications.


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