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County staff warn July 1 PBM dispensing fee could raise out‑of‑pocket costs for local employees
Summary
Presenters told the board a new Kansas law (effective July 1) will impose a $10.50 dispensing fee on prescriptions filled in Kansas for non‑ERISA employers; county staff said the county is affected, are evaluating mail‑order and 90‑day strategies, and described lingering operational uncertainty with PBMs.
County benefits staff and outside consultants briefed commissioners about a newly enacted pharmaceutical‑benefit‑manager (PBM) reform bill that takes effect July 1 and imposes a per‑dispense dispensing fee on prescriptions filled in Kansas. The presenter said the fee is $10.50 per dispensed drug and will apply to non‑ERISA public employers, which includes Montgomery County. "You are, unfortunately, affected by this $10.50 dispensing fee," the presenter said, advising the county that implementation details were still being worked out with PBM partners.
Commissioners pressed staff on likely mitigation strategies including stronger promotion of mail‑order fills or larger 90‑day retail fills. Presenters said mail‑order or out‑of‑state fills likely would not trigger the Kansas dispensing fee but cautioned that PBMs, pharmacy workflows and vendor responses were still evolving and county staff were consulting compliance and insurance authorities. Commissioners asked staff to return with specific examples showing which commonly used drugs and co‑pay combinations would see increases and how 90‑day fills might be handled.
