Senate health panel holds multiple PBM reform bills targeting spread pricing and reimbursement transparency

PROVIDENCE, R.I. — The Senate Committee on Health and Human Services on March 20 heard testimony and held a package of bills aimed at pharmacy benefit managers, or PBMs, with members saying reform is needed to protect Medicaid, commercial plan sponsors and independent pharmacies.

Senators took the first procedural action on a set of measures including Senate Bill 117 and Senate Bill 173 (both addressing Medicaid PBM practices), Senate Bill 165 (a straight prohibition on spread pricing), and Senate Bill 221 (an omnibus commercial PBM bill that would require more disclosure and consider NADAC-like pricing for commercial plans). All of the bills were formally “held” for further study by voice vote at the end of the hearing.

Supporters — including sponsor Senator Ujifusa and the Rhode Island Black, Latino, Indigenous and AAPI caucus — described PBMs as intermediary firms that take money from plans or taxpayers and pay pharmacies and providers. “PBMs are middlemen for middlemen,” said Senator Ujifusa, arguing that spread pricing and rebate-driven formularies can divert savings away from patients and providers. Independent…