Alaska Governor Approves PBM Regulation

October 8, 2024

EGWP marketplace medicaid Medicare

After delaying a decision for several months, Alaska Gov. Mike Dunleavy (R) signed HB 226, an anti-PBM bill that passed by the legislature earlier this year. The bill contains problematic language that could ultimately raise costs and reduce choice for employers and consumers. Those provisions include restrictions on the use of white bagging and home delivery; any willing provider language; a prohibition against spread pricing contracts; as well as changes to drug pricing methodology, labeling, and Maximum Allowable Costs (MAC) lists. Lastly, the law requires PBMs to maintain a “duty of care” with health plans that they contract with for pharmacy services.

Fortunately, during the legislative process, the bill was significantly amended to remove some of the costliest provisions, including the elimination of National Average Drug Acquisition Cost (NADAC) pricing, dispensing fee mandates, and applicability to Employee Retirement Income Security Act of 1974 (ERISA) plans and public sector plans. As a result, only the fully insured market, estimated to be appropriately 14% of the commercial market, will be impacted by the new law. The legislation is effective on Jan. 1, 2025.

legislation

House Judiciary Subcommittee Holds Hearing on the Role of PBMs

On Sept. 11, the House Judiciary Subcommittee on the Administrative State, Regulatory Reform, and Antitrust held a hearing titled, “The Role of Pharmacy Benefit Managers,” featuring academic witnesses. The hearing focused on transparency, affordability, and access, as well as the relationship between PBMs and independent pharmacies. Witnesses highlighted the critical role of PBMs in the […]
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October 8, 2024

EGWP marketplace medicaid Medicare

Initiatives

House Education and the Workforce Committee Holds Hearing in Honor of ERISA 50th Anniversary

On Sept. 10, the House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions held a hearing titled, “ERISA’s 50th Anniversary: The Value of Employer-Sponsored Health Benefits.” Policy experts and advocates representing large employers, small business owners, and consumers discussed potential ways to strengthen the Employee Retirement Income Security Act (ERISA) and employer-sponsored coverage. […]
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October 8, 2024

EGWP Medicare

legislation

Texas Pharmaceutical Initiative Board Approves Business Plan

Recently, the Texas Pharmaceutical Initiative (TPI) Board unanimously approved the TPI Business Plan for improving PBM services, finding administrative savings, and lowering drug costs. The TPI Board adopted the Plan after several changes that were finalized during the meeting. In the area of Medicaid services, Board Chairman Mike McKinney, MD, acknowledged that other states achieved […]
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October 8, 2024

EGWP marketplace medicaid Medicare

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