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Subcommittee forwards PBM‑reform substitute aimed at greater rebate pass‑through and anti‑steering rules
Summary
A broad substitute to HB 830 that bans certain PBM practices, requires rebate pass‑through or transparent fee models, and mandates consumer protections was reported out to appropriations after broad testimony from pharmacists, independent pharmacies and health plans; the governor signaled support.
Del. Colson presented a substitute to HB 830 that would strengthen oversight and transparency of pharmacy benefit managers (PBMs), require PBMs to pass rebate savings through to lower patient cost sharing or offer alternative fee models, prohibit certain steering and predatory practices toward pharmacies, and enable plan sponsors to select a fee model that delinks PBM revenue from drug prices.
The governor’s office (via Lucy Schwartz) endorsed the bill as an initial step to lower prescription drug costs. Pharmacists, community pharmacy representatives and patient groups urged passage, describing PBM practices that they say disadvantage community pharmacies and raise consumer costs. "This bill bans PBMs predatory callbacks, requires that PBMs pass through their rebate savings for the purpose of lowering costs for the patient, and enforces fair business practices," said a governor’s office representative.
Health plans, PBM trade groups and some industry witnesses acknowledged the intent but raised concerns about market effects, contracting complexities and potential implementation costs. The Virginia Association of Health Plans and PBM representatives asked for continued negotiation on certain provisions. Supporters said the substitute included changes responsive to stakeholder concerns, including procurement timelines for a proposed state PBM option and protections for independent pharmacists.
After extensive testimony and questions from the committee, the subcommittee reported the substitute and referred HB 830 to appropriations for further review.
