Who Is Opposed?
Misinformation, disinformation, and fear tactics kill progress!
Big Business Has Been Fooled
Lobbyists for PBM's use the same strategy all around the United States. They tell big businesses that PBM reform would lead to increased premiums, which would have to be passed down to employees.
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​Specific parts of HB1123 (as amended) that received push-back:
Section 4 (Appeals Section)
Section 4 addressed appeals. It allowed for pharmacists to submit invoices, when paid less than acquisition cost, to be made whole. It went a step further by allowing any appeal in the State to apply to all pharmacies on that same date.
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Argument Against:
Appeals should not apply to all independent pharmacies in the State on any given day, instead each pharmacy should have to submit their own appeal.
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Argument For:
When an appeal is made and supported by an invoice, it should apply to every independent pharmacy on that date because everyone should be made whole.
Section 7 (Steering Section)
Section 7 prohibited the steering of patients to affiliated pharmacies or interfering in any way with a patient's right to choose the pharmacy of their choice.
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Argument Against:
Some claim that this would negatively impact patients who receive high cost (specialty) medications. Certain PBM's steer patients taking specialty medications to certain specialty pharmacies, claiming the patient is getting the best price, therefore decreasing the financial burden placed on the employers self-insured plan.
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Argument For:
The language in the bill specifically stated "affiliated pharmacy", therefore unless the PBM's had financial interest within the pharmacy, this section would NOT hinder the steering of specialty medications. Patients should have the right to choose where they use their own insurance. Not allowing insurance to cover medications at a pharmacy, simply because the pharmacy is unaffiliated with the PBM, is un-American. Steering is leading to numerous pharmacy closures and ultimately harming both access to care and quality of care.