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Administration proposes PBM licensure and PBM data reporting to HCAI; DMHC to enforce compliance
Summary
The Governor's May Revision would require pharmacy benefit managers that contract with health plans or insurers to obtain a state license and to report detailed pricing and financial data to the Healthcare Payments Data program, officials from HCAI and DMHC told an Assembly budget subcommittee on May 23.
The May Revision proposes a two-part approach to increase transparency in prescription drug pricing: requiring pharmacy benefit managers (PBMs) that contract with California health plans or insurers to obtain licensure and authorizing expanded data reporting to the Health Care Payments Data (HPD) program administered by the Department of Health Care Access and Information (HCAI).
Elizabeth Landsberg, HCAI director, told the Assembly Budget Subcommittee No. 1 on Health that the agency would require PBMs to become mandatory submitters to the HPD, which would collect PBM-specific data such as wholesale acquisition costs, average wholesale price, national drug codes, fees and rebates paid across the supply chain,…
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