Oregon hearing on PBM reform draws pharmacists, insurers and state regulators to Capitol

Salient testimony at a House committee hearing Tuesday put the struggles of Oregon pharmacies at the center of a long, technical debate over how the state should regulate pharmacy benefit managers (PBMs).

The House Committee on Behavioral Health and Health Care opened a public hearing on House Bill 3,212 on Feb. 4 in Salem. Committee members heard a 20‑minute overview from the Department of Consumer and Business Services, followed by testimony from pharmacists, national trade groups, PBMs, insurers and community advocates.

The bill’s sponsors and pharmacy groups told lawmakers HB 3,212 would require PBMs that operate in Oregon to stop “spread pricing,” adopt cost‑plus or NADAC‑based ingredient reimbursement with a separate professional dispensing fee tied to the Medicaid fee‑for‑service survey, bar network steering to PBM‑owned pharmacies, and prohibit certain contract terms they say force pharmacies to fill loss‑making prescriptions. "We need you to finally, as you've said in the past, stop that bleeding," said Nikki Terziaff, executive director of the Oregon State Pharmacy Association. "Our Oregon pharmacies are dying so that their patients won't."

State regulators briefed the committee on how Oregon arrived at the current framework. Jesse O’Brien, policy manager at the Division of Financial Regulation, said HB 4,149 from the 2024 short session moved Oregon from a PBM registration model to a licensure model, giving the agency new powers to require reporting, request contracts and exams, and to enforce penalties. "The Division of Financial Regulation is the state's regulator of PBMs," O’Brien told the committee, explaining the department’s authority and the implementation work now under way.

Noomi Raefold Griffith, senior policy adviser at the Division of Financial Regulation, walked members through PBM mechanics, reimbursement formulas and market…