Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Healthcare Finance topic
No spam. Unsubscribe anytime.
Senators introduce bill to regulate pharmacy benefit managers and set reimbursement standards for pharmacies
Summary
A multi‑sponsor bill to regulate pharmacy benefit managers (PBMs) and to create an objective reimbursement standard for pharmacies was introduced and discussed on the Senate floor. Supporters said the measure would improve transparency and curb spread pricing; the bill was referred to the Banking and Insurance Committee.
Senators introduced legislation aimed at regulating pharmacy benefit managers (PBMs) and establishing a transparent reimbursement standard for pharmacies serving South Carolina residents.
Sponsors of the bill argued the current PBM arrangements leave independent and rural pharmacies unable to predict or recover their costs. A sponsor described the measure as one that would require PBMs to use the national average drug acquisition cost and pay a fair dispensing fee, ban spread pricing and allow pharmacies an appeal to the Department of Insurance when underpaid. The sponsor said the bill would also limit the Department of Health and Human Services (DHHS) to contracting with no more than two managed‑care PBMs and would give the attorney general enforcement authority under existing unfair trade practices powers.
During floor remarks, the senator from Newberry, who identified himself with the independent pharmacy sector, gave a specific example of the pressures pharmacies face: he said a recent Medicaid payment “paid us $4.21 for the drug, and they paid us a nickel for a dispensing fee,” which in his account meant the pharmacy lost money when fixed dispensing costs are considered.
Why it matters: supporters say the bill would help rural pharmacies remain viable, improve payment transparency and prevent vertically integrated PBMs from using opaque pricing to undercut community pharmacies. Opponents were not recorded in detailed floor debate during this session; the bill was referred to the Banking and Insurance Committee for further review.
Next steps: the bill was referred to the Banking and Insurance Committee for hearings and consideration.
Ending: The issue of PBM regulation has been raised in multiple sessions of the General Assembly and generated floor time and public comment; this bill is now in committee for legislative development.
