Search
  • Robert Alongi

Supreme Court Reviews PBM Regulation Case

Dear Pharmacists,

On Tuesday, October 6th, the Supreme Court heard arguments concerning the regulation of the pharmacy benefit managers (PBMs) at the state level. This will address the concerns of PBMs buying generic medications and making huge profits while making pharmacies (especially independents) get little reimbursement. The process can cause independent community pharmacies to be taken advantage of by PBMs and cause them financial disaster and/or close their business.

According to an article posted by Roll Call (source https://www.rollcall.com/2020/10/06/supreme-court-hears-drug-benefits-case-with-wide-ranging-impact/ ), “The law requires PBMs to grant an appeal if a pharmacy can prove the reimbursement rate for a drug is lower than its acquisition cost, and it allows pharmacies to decline to dispense the prescription.” Depending on the ruling of the Supreme Court, this may change how states regulate PBMs in the future and help pharmacies in rural areas, especially independent community pharmacies. While a decision has not been reached, we may see a ruling within the next year.

For more information:

https://www.rollcall.com/2020/10/06/supreme-court-hears-drug-benefits-case-with-wide-ranging-impact/

https://ncpa.org/newsroom/qam/2020/10/06/supreme-court-hears-arguments-pbm-case

https://www.wkrn.com/washington/washington-dc/supreme-court-hears-arguments-over-pbm-payments-to-pharmacies/#:~:text=Supreme%20Court%20hears%20arguments%20over%20PBM%20payments%20to%20pharmacies,-Washington%20D.C.%20Bureau&text=WASHINGTON%20(NEXSTAR)%20%E2%80%94%20The%20U.S.,the%20cost%20of%20prescription%20drugs.

https://www.drugtopics.com/view/us-supreme-court-proceeds-with-hearing-on-landmark-pbm-regulation-case

6 views0 comments

Recent Posts

See All

Medicare Open Enrollment Begins Today!

Open enrollment for Medicare health and drug plans began today! Now is a wonderful opportunity to encourage your patients who are currently enrolled in Medicare Advantage and/or prescription drug plan

COVID-19 Booster Billing Codes Issued

The National Community Pharmacists Association (NCPA) has updated its COVID-19 vaccine billing and reimbursement handout to reflect the changes in the National Council for Prescription Drug Programs'