Medicare Compliance & Reimbursement

PHARMACIES:

New Bill Brings Hope For PBM Reforms

Kickbacks are one concern.

Stay tuned this summer for developments in a new effort to level the playing field between pharmacies and pharmacy benefit managers (PBMs).

More than 50 community pharmacists in Vermont have signed and sent a letter to Senate Judiciary Chairman Patrick Leahy (D-VT) urging him to take legislative action to revamp the nature of PBMs.

PBMs, largely unregulated, control 80 percent of the drug coverage in the United States, giving them a big competitive edge over retail pharmacies.

The move is essential to the survival of the nation's 24,000 independent community pharmacies, including 87 pharmacies in Vermont, says the National Community Pharmacists Association. In many smaller communities in Vermont, pharmacies are the primary health-care resource.

In their letter, the pharmacy owners encourage Chairman Leahy to introduce legislation similar to H.R.971, the Community Pharmacy Fairness Act of 2007. That bill has already has attracted more than 100 House cosponsors, including the chairman of the House Judiciary Committee, Rep. John Conyers (D-MI).
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