Oregon Governor John Kitzhaber (D) has signed H.B. 2123 into law. The ground-breaking reform legislation applies reasonable standards to how pharmacy benefit managers (PBM) audit community pharmacies, provides increased transparency into generic prescription drug reimbursement, and ensures that PBM administrators of prescription drug claims are registered within the state.
This legislation’s enactment comes after a yearlong negotiation process. Members of a Pharmacy Working Group, consisting of Oregon pharmacists, representatives of the Oregon Pharmacy Association, the National Association of Chain Drug Stores (NACDS), the National Community Pharmacists Association (NCPA), the Oregon Pharmacy Coalition, state legislators, and representatives of the PBM community collaborated on these issues, resulting in the enacted law.
In response, NCPA CEO B. Douglas Hoey, RPh, MBA, issued the following statement:
“Oregon is demonstrating its leadership in the health care arena. With the stroke of Governor Kitzhaber’s pen, H.B. 2123 has become law. After a little more than a year of steady leadership and consensus-building efforts by State Representative Jules Bailey (D-Portland) and all the participants in the Oregon Pharmacy Working Group, this legislation has been enacted.
“This new law will help Oregon’s clinically trained pharmacists – the medication experts – to devote more time to their patients. The bill contains three notable provisions that will ultimately benefit any Oregon patient who enters a retail pharmacy, especially the more than 150 independent community pharmacies in the Beaver State.
“First, H.B. 2123 will help rein in egregious pharmacy audit practices. Community pharmacists support reasonable oversight to combat waste, fraud and abuse. However, audits of pharmacies often are a profit-seeking expedition predicated on recouping money based on minor technicalities or trivial clerical errors.
“Second, the legislation gives pharmacists some basic insight into the guessing game that is their generic prescription drug reimbursement. In addition, health plans covered under the law are required to update their reimbursement rates more frequently to better reflect the pharmacy’s actual drug acquisition costs, which can increase dramatically and virtually overnight.
“Third, H.B. 2123 requires PBMs to register with the Insurance Division of Oregon, an important step toward some level of regulatory oversight of the drug benefit management industry within the state.
“As Rep. Bailey previously stated, ‘My interests in this legislation come from listening to my constituents. Patients tell me about their maddening experiences navigating the PBM bureaucracy to get vital prescription drugs at a reasonable price and in a timely fashion. Pharmacists tell me about how PBMs squeeze them to the breaking point as a result of the onerous, take-it-or-leave-it contracts they must sign to have access to patients and about abusive PBM audit practices. The universal complaint is that the current system is broken.’ With H.B. 2123 now on the books, Oregon’s delivery of prescription drug services will be fairer and more efficient.
“Congratulations to Rep. Bailey and to Oregon pharmacists, whose efforts NCPA was proud to support. We hope Oregon’s legislative example becomes part of a nationwide trend. States are often the laboratories of democracy. All too often, the push for national reform must reach a critical mass in the states before action occurs at the federal level. Bills like H.B. 2123 offer a roadmap to a better future not only in Oregon, but hopefully for the rest of America.”
Source: Northwest Primary Care Association