Nov. 25, 2020

HARRISBURG – Legislation by Rep. Seth Grove (R-Dover) to provide a voice to community pharmacists by requiring they are represented on the Pharmacy and Therapeutics Committee is now law.

“This act was part of a package of bills to address serious problems and unethical practices by pharmacy benefit managers (PBMs),” said Grove, who is a House co-chair of the Pennsylvania Community Pharmacy Caucus. “For the better part of the session, my colleagues and I have been working to end certain practices that drastically impact small, often family-owned pharmacies and consumers.”

Specifically, the new law adds two community pharmacists to the committee. The committee makes recommendations on pharmaceutical programs to the department secretary.

The representatives heard numerous stories of how some large PBMs drastically slashed reimbursements to independent pharmacists while larger pharmacies were unaffected. Some of the owners of these mom-and-pop pharmacies were then offered by large chain pharmacies to buy their business. The reduced reimbursements were often cited as reasons why they should sell.

Another unethical practice are gag clauses to forbid pharmacists from telling consumers the out-of-pocket cost for a prescription is less than their insurance co-pay. This practice directly hits consumers in the wallet and puts profits before the financial health of customers.

“All Pennsylvanians should be angered by these practices, which put profits over patients,” Grove said. “Health care costs continue to increase, and, in these cases, the increase is the result of shady dealings by PBMs.”

Three additional bills in the package:

House Bill 941, which was sign into law as , increases transparency in PBM pricing practices in Medicaid and address inadequate reimbursement rates for pharmacies.

House Bill 943, which was signed into law at Act 67 of 2020, eliminates gag orders on pharmacists to ensure pharmacists are able to help consumers select lower price prescriptions.

House Bill 944 would have allowed the Office of the Auditor General to conduct a full-scale audit of subcontracts with PBMs in Medicaid.

Representative Seth Grove
196th District
Pennsylvania House of Representatives

Media Contact: Greg Gross
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