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Representative Nadeau advances single-PBM model for Medical Assistance drug benefit; pharmacies urge rescue
Summary
House File 2,242 would create a single pharmacy-benefits administrator model for Medical Assistance, aiming to increase pricing transparency, stop spread pricing, and reimburse community pharmacies at or near acquisition cost plus dispensing fees.
Representative Nadeau introduced House File 2,242 to authorize a single pharmacy benefits administrator (a single PBM/PBA-style model) for the Medical Assistance (MA) pharmacy benefit. The bill’s language updates payment definitions, procurement rules for a single administrator, and seeks to stop PBM practices such as spread pricing and other nontransparent contractor fees.
Nadeau and testifiers—community pharmacists and pharmacy-aligned organizations—framed the measure as a response…
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