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Senate panel hears bill to require single PBM for Nevada Medicaid
Summary
Sen. Melanie Scheibel told the Senate Health and Human Services Committee that SB389 would require Nevada’s Medicaid program to contract with a single pharmacy benefit manager, prohibit spread pricing and align with federal law; pharmacists, pharmacy groups and patient advocates testified in support.
Sen. Melanie Scheibel (District 9) opened a hearing on Senate Bill 389, saying the measure would require Nevada’s Medicaid program to contract with a single pharmacy benefit manager (PBM) and prohibit spread pricing.
"This bill in short will require, the state Medicaid plan to switch to a single PBM, a single pharmacy benefit manager," Scheibel said during the hearing.
Why it matters: Supporters said consolidating pharmacy benefit management under one contractor would improve pricing transparency, strengthen the state’s bargaining position and reduce administrative burdens for pharmacists and patients who currently face inconsistent formulary and prior-authorization requirements across multiple managed care organizations (MCOs).
What the bill would do: Scheibel described the bill as requiring the Department of Health and Human Services' Nevada Medicaid program to issue a request for proposals, evaluate applications and enter into a contract under the department’s procurement authority. An amendment posted on NELIS was described by Scheibel as technical, clarifying references to federal statutes.
Support testimony: Dozens of pharmacists and pharmacy organizations spoke in support during the hearing, including representatives of the Nevada Pharmacy Alliance, Nevada Society of Health System Pharmacists, Washoe Tribal Health Center pharmacy staff and multiple independent pharmacists.
- Adam Porath, representing the Nevada Society of Health System Pharmacists, said pharmacists find it "very frustrating" to manage multiple PBMs that produce different formularies and prior-authorization rules for the same patient.
- Evan Williams of the Nevada Pharmacy Alliance cited savings from other states (Ohio, Kentucky) that moved to a single-PBM model and said it can protect rural and independent pharmacies from unfair reimbursement rates.
Opposition and neutrality: The hearing record contained no callers in opposition. A small number of neutral or clarifying comments were requested and the committee recessed briefly to verify remote connections.
Outcome at the hearing: The committee closed the hearing after providing Las Vegas attendees a second opportunity to testify. No final vote on the bill occurred during the hearing; it proceeded to later work session consideration.
Ending note: Senator Scheibel left for another committee meeting and did not offer closing remarks before the hearing record was closed. The hearing record includes a posted amendment on NELIS intended to ensure federal compliance.
