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Sponsors introduce bill to curb PBM practices, require drug-claims transparency
Summary
At a House Insurance Committee hearing, sponsors of House Bill 192 said the Community Pharmacy Protection Act would ban retaliatory PBM practices, limit PBM-imposed accreditation and auditing requirements, and require monthly, machine-readable drug-claims reporting to plan sponsors to reveal acquisition costs.
Representative Tim Barhorst and Representative Tex Fisher testified before the Ohio House Insurance Committee on House Bill 192, the Community Pharmacy Protection Act, saying the measure would limit pharmacy benefit managers’ (PBMs) ability to terminate contracts, impose surprise audits and require PBM-imposed accreditation as a condition of network participation.
Sponsors said the bill focuses on three PBM tactics they say are driving independent and non‑PBM pharmacies out of business: low reimbursement rates, patient steering, and retroactive fees similar to clawbacks. “This legislation's primary purpose is to address a market failure created by this problem,” Representative Tim Barhorst said in sponsor testimony. Barhorst warned that Ohio is seeing “pharmacy deserts” as independents close,…
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