Supreme Court Reviews PBM Regulation Case
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.
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