https://who13.com/news/iowa-gov-reynolds-signs-bill-to-reform-pharmacy-benefit-managers/
DES MOINES, Iowa (KCAU) — Iowa Gov. Kim Reynolds signed a bill Wednesday aimed at bringing changes to pharmacy benefit managers, also known as PBMs.
The legislation, Senate File 383, aims to help prevent more independent and rural pharmacies from closing their doors in the Hawkeye State.
PBMs are the middlemen between health insurance companies and pharmacies. Whenever you fill a prescription, the PBM determines how much the pharmacy actually gets paid for dispensing your medication.
In recent years, that amount has sometimes been less than what it costs the pharmacy to fill a prescription, forcing them to either refuse the fill, or take a financial loss.
Senate File 383 would attempt to prevent that by adding requirements for how much pharmacies must be reimbursed for filling medications, to ensure they get paid a fair price.
It also adds other patient protections, like preventing PBMs from hitting you with a monetary penalty if you choose a non-preferred pharmacy, or requiring you to use a mail-order pharmacy service to use your insurance coverage.
As of Wednesday, a total of 32 states have passed similar legislation, according to the Iowa Governor’s Office.
Opponents of the measure have argued the bill would increase health insurance premiums, but supporters maintain that in states that have previously passed similar legislation, that has not come to pass.
Governor Reynolds released a statement Wednesday explaining her reasoning for signing the bill. In part, it says, “The new bill takes steps toward addressing these challenges by targeting PBM practices that harm both patients and independent pharmacies. Local pharmacies, especially in rural areas, are vital to community health and local hospitals but are being driven out by opaque, one-sided contracts.”
You can read the governor’s full statement here.
The Iowa Pharmacy Association applauded the bill’s passage Wednesday. CEO Kate Gainer said, “Governor Reynolds’ leadership and the Iowa Legislature’s bipartisan support of SF 383 sends a powerful message that the health of Iowa communities comes first. For too long, PBMs have put profits over patients, contributing to the closure of more than 200 pharmacies in Iowa since 2014. This law gives us the tools to level the playing field and protect access to care, especially in rural areas.”
The Iowa Association of Business and Industry, however, opposed the bill’s signing, releasing a statement saying, “ABI is disappointed in today’s action. ABI testified at every turn in favor of legislation that would support small independent pharmacies in Iowa. The bill that the Governor signed today is not that. Senate File 383 includes expensive, unneeded provisions that are going to drive up the costs of pharmacy services in Iowa without any discernable improvement in patient care. Iowans – including businesses and employees – will bear these costs at the pharmacy counter and in the structure of their health care plans. This is an additional headwind in an already challenging business environment. Now law, ABI will take every opportunity to mitigate the increased costs on our members and their team members throughout Iowa.”
Filed under: General Problems
So everybody wants to help make conditions better for patients, but different people have opposite ideads of how to achieve this?