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Insurance department says PBM reimbursement reports will be processed using existing actuarial contract
Summary
The Department of Insurance told the Joint Budget Committee it expects to receive several hundred pharmacy benefit manager reimbursement reports by the Feb. 17 deadline and will use an existing actuarial contract to process the data rather than hiring additional staff.
The Joint Budget Committee reviewed a report on pharmacy benefit manager (PBM) reimbursements and enforcement activities and heard that the Insurance Department expects a large volume of filings ahead of a Feb. 17 deadline.
Alan McLean, Insurance Commissioner, and Jimmy Harris, deputy commissioner, told the committee the department has the technology to receive large datasets electronically and plans to rely on an existing contract with an actuarial firm to analyze the filings. Harris said the actuaries will do the “number crunching” and the department does not anticipate hiring additional permanent staff to handle the expected influx.
Members asked about turnaround time and staffing. McLean and Harris said the department expects most submissions to arrive close to the statutory deadline and anticipates it can process filings in a matter of weeks using the actuary contract. Harris described the actuary arrangement as a standing contract the department uses for other actuarial needs and said using that retainer will cover the additional workload without creating a new permanent position.
The committee recorded the item as reviewed; there was no request for additional appropriation at the meeting.
Ending: Committee members thanked the department for revisiting prior PBM analyses (including a 2020 report) and concluded review of the item.
