Mississippi Senate approves pharmacy benefit manager reform, sends bill back to House
The Mississippi Senate approved a bill intended to increase transparency of pharmacy benefit managers and change reimbursement rules for pharmacists, passing the measure 44-7 on Tuesday, Senate leaders said. The Senate adopted an amendment by Republican Sen. Rita Parks that replaced the House’s original language and sent the legislation back to the House for further consideration.
Parks, a Corinth lawmaker who has led PBM reform efforts in the Senate for years, said her amendment to House Bill 1665 added provisions requested by independent pharmacists to ensure fair and transparent payment for dispensing drugs. Parks said the bill would increase reporting requirements, prohibit spread pricing and require pharmacists be reimbursed at least as much as an affiliate pharmacy or the Mississippi Division of Medicaid, which pays the drug cost plus a dispensing fee.
Parks said the changes are needed to preserve access to care in rural communities after independent pharmacists warned they could be forced to close because of low reimbursements. “Can we afford to not do anything as a state?” she asked. Parks also said the business community has used “scare tactics” against reform and cited data from the Division of Medicaid showing savings since the agency implemented its current reimbursement policy in 2017.
Several Republican senators urged keeping the House text, saying the Senate language would raise costs. Sen. Jeremy England of Vancleave argued the payment model in the Senate bill would drive up prescription costs that would be passed to Mississippi businesses and employees, and presented a memo from the Legislative Budget Office estimating the bill would add $34 million in costs to the State Health Plan. “This is bad policy,” England said. “This is going to cost our job creators money.” England also cited a letter from the Mississippi Business Alliance warning that higher prescription costs could prompt employers to drop health plans.
The Senate kept oversight of pharmacy benefit managers with the state Board of Pharmacy rather than transferring regulation to the insurance commissioner, as the House had proposed. Parks said Insurance Commissioner Mike Chaney told her he believes PBMs should be regulated by the Board of Pharmacy and that moving oversight to the insurance department could take at least two years. Sen. Daniel Sparks of Belmont noted the LBO estimate England cited was provided by CVS, which owns CVS Caremark, one of the nation’s largest PBM companies.
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