Latest news with #JeremiahMoore
Yahoo
29-05-2025
- Business
- Yahoo
Two federal lawsuits challenge Arkansas anti-PBM law
Rep. Jeremiah Moore (right), R-Clarendon, and Sen. Kim Hammer (second from right). R-Benton, listen to opposition to House Bill 1150 from Randy Zook, president of the Arkansas Chamber of Commerce, during the Senate Committee on Insurance and Commerce meeting on Tuesday, April 8, 2025. (Tess Vrbin/Arkansas Advocate) Two federal lawsuits filed Thursday argue that a new state law will harm hundreds of thousands of Arkansans by affecting access to needed medications. Two of the country's largest pharmacy benefit managers (PBMs) filed the complaints in the U.S. District Court for the Eastern District of Arkansas, both arguing that Act 624 of 2025 violates the U.S. Constitution by interfering with interstate commerce. The suits also allege that federal law preempts state laws that affect employee health plans and Medicare coverage. The suits filed by Express Scripts Inc. and CVS Pharmacy Inc. name the eight members of the Arkansas State Board of Pharmacy and its executive director as defendants. The new law empowers the pharmacy board to enforce its provisions. Both complaints ask the court to bar enforcement of the law as well as declare it unconstitutional. Act 624 'imperils the health' of 50,000 Arkansans who rely on Express Scripts for pharmacy benefits through their health insurance, the PBM's complaint says. The General Assembly created the law 'for the exclusive benefit of Arkansas-based pharmacies who spearheaded the legislation in order to increase their market share by eliminating out-of-state competition,' the complaint states. Health insurer Cigna owns Express Scripts; CVS Pharmacy owns the PBM Caremark Rx. Together with OptumRx, owned by United Healthcare, the PBMs manage 79% of prescription drug claims for approximately 270 million people, according to a 2024 Federal Trade Commission report. Arkansas became the first state in the nation to ban large, vertically integrated healthcare companies from also operating drugstores in the state when Gov. Sarah Huckabee Sanders signed House Bill 1150 into law in mid-April. The law doesn't take effect until January 2026. 'If left to stand, the law will have devastating consequences across Arkansas — including forcing numerous pharmacies operating in the state out of business, costing the more than 600 Arkansans employed at those pharmacies their jobs, and creating pharmacy 'deserts' for the nearly 40% of Arkansans who live in rural areas that often lack brick-and-mortar pharmacies,' Express Scripts asserts in its complaint. 'The law will also dangerously limit patient choice and deny access to lifesaving drugs at affordable prices by high-quality pharmacy providers. And it will create mass confusion among Arkansans about where and how they can receive needed prescription medications,' the suit adds. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX In its complaint, CVS says that if the law takes effect on Jan. 1, the company 'will have to cease not only its operations at 23 CVS retail pharmacies across the State, but also its mail-order and specialty-pharmacy services. Indeed, the law will likely shut down a substantial portion of all mail-order and specialty-pharmacy prescriptions flowing into the State because the majority of such providers are out-of-state pharmacies with PBM affiliations.' The complaint notes that CVS's 23 pharmacies served more than 340,000 patients and filled over 2.4 million prescriptions in 2024. Complying with the law will impose undue burdens on CVS because of the intricacies of its corporate structure, the complaint says. CVS further claims the law already has begun affecting its business, as it has lost patients to in-state competitors and it's become harder to attract and retain employees in Arkansas. The CVS complaint calls Act 624 'a blatantly protectionist measure,' a characterization echoed in Express Script's argument for a court-ordered injunction: 'Because Act 624 is unconstitutionally protectionist, unconstitutionally punitive, and preempted by federal law, enforcement of the statute must be enjoined.' Both lawsuits argue that the Arkansas law violates various commerce provisions of the Constitution, and CVS argues that it violates the equal protection clause by banning CVS and most other PBM-affiliated pharmacies from Arkansas while exempting 'the only Arkansas-based pharmacy affiliated with a PBM [Walmart], without a rational justification for this distinction.' Express Script's complaint also notes that Act 624 will adversely affect members of the military, their families and veterans because the PBM is the primary mail-order pharmacy provider for Tricare, the military's health insurance program. The law allows the state pharmacy board to issue limited permits to PBMs if they provide 'drugs that are otherwise unavailable in the market to a patient or a pharmacy that would otherwise be prohibited' under the law. Republican Sen. Kim Hammer of Benton, the law's co-sponsor, told the Senate this will allow Tricare beneficiaries to continue receiving medications while PBMs transition out of Arkansas. Attorney General Tim Griffin said in a statement that 'Arkansas is standing up to PBMs on behalf of consumers' via Act 624 and vowed to defend the law. 'Pharmacy benefit managers wield outsized power to reap massive profits at the expense of consumers. The rise of PBMs as middlemen in the prescription drug market has resulted in patients facing fewer choices, lower quality care, and higher prices. PBMs leverage their affiliated pharmacies to manipulate prices, corrupt the market, and destroy competition,' Griffin said, echoing many of the talking points of the law's proponents as it made its way through the Legislature. Shortly before Act 624 became law, Griffin was the lead signatory of a bipartisan letter to Congress from attorneys general in 39 states and territories, advocating for the policy in Act 624 to be enacted federally. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
03-04-2025
- Business
- Yahoo
Proposed ban on drug middlemen owning retail pharmacies passes Arkansas House committee
Little Rock pharmacist Brittany Sanders (left), Arkansas Pharmacists Association CEO John Vinson (second from right) and Rep. Jeremiah Moore (right), R-Clarendon, present House Bill 1150 to the House Committee on Insurance and Commerce on Wednesday, April 2, 2025. (Tess Vrbin/Arkansas Advocate) A House panel Wednesday approved a bill aimed at preventing pharmacy benefit managers (PBMs) from holding a permit to operate a drug store in Arkansas. Opponents outnumbered supporters in the public comment period of the House Insurance and Commerce Committee meeting, but a majority of the panel's 21 members voted to send House Bill 1150 to the full House. PBMs negotiate prescription benefits among drug manufacturers, distributors, pharmacies and health insurance providers, and they rank prescription drugs with the highest-tiered products costing consumers the lowest out-of-pocket costs. The Federal Trade Commission released an interim report in July 2024 saying these conglomerates are eliminating competition and increasing drug prices at the expense of patients. 'Pharmacy benefit managers are gaming the system to line their own pockets with taxpayers' and patients' money,' said HB 1150 sponsor Rep. Jeremiah Moore, R-Clarendon. He decried the 'patently false' statements circulating about the potential impact of HB 1150 from those who oppose it, such as the idea that 2.7 million Arkansans would lose access to health care. HB 1150 has faced a marketing campaign against it in the two and a half months since it was filed, and Moore said the opposition has primarily come from PBMs. Arkansas lawmakers seek to ban prescription drug middlemen from owning pharmacies in the state Some of Wednesday's opponents of HB 1150 represented corporate health care organizations, including Russell Harper, a government relations executive with the Navitus Health Solutions PBM. Harper said the bill 'will result in lots of unintended consequences that will bring patient disruption, patient confusion and patient access issues to important drug treatments, not just in the commercial market, but in Medicare, Medicaid and Tricare.' He claimed a wide swath of Arkansas pharmacies, including 23 within CVS and 26 within Kroger, would be at risk of closing if HB 1150 passes. John Vinson, CEO of the Arkansas Pharmacists Association, denied the allegation that HB 1150 would force pharmacies to close by taking PBMs out of the competitive pharmacy market. 'It gives pharmacies a choice of whether they want to be a PBM or a pharmacy,' Vinson said. '[They would] pick one or the other.' Several PBMs are affiliated with interstate mail-order pharmacy operations, and House Bill 1150 includes mail-order pharmacy permits among those that PBMs would be prohibited from holding. Vinson said Wednesday that some PBMs force consumers to receive their medications via mail, which costs more than receiving them over the counter. Mike Castleberry claimed HB 1150 would reduce mail-order pharmacies' presence in Arkansas to the point that patients would not be able to access necessary medication. Castleberry is chief revenue officer at Consociate Health, which represents 'self-funded employers' in Arkansas, and he said many pharmacies can only afford to provide specialty drugs if they use mail-order operations. 'The first phone call that y'all are going to get from your constituents [if HB 1150 passes] is someone who's on a specialty drug,' he said. Randy Zook, president of the Arkansas Chamber of Commerce, said lawmakers should not make laws that attack vertical integration in business, but Vinson and Moore both said PBMs' vertical integration is unique because they set their competitors' prices. Federal regulator: Pharmacy middlemen appear to be raising prices, hurting patients OptumRX, Express Scripts and CVS Caremark — the three largest PBMs — are each owned by much larger corporations that each also own a top-10 health insurer. Together they control about 80% of the U.S. prescription market, according to last year's Federal Trade Commission report. CVS Caremark is a subsidiary of CVS Health, and District Leader of Pharmacy Operations Ashley Ellis expressed opposition to HB 1150 on Wednesday. Ellis said pharmacists that work for PBM-owned and corporate pharmacies are still members of their local communities, and they have access to the medications and equipment that serve people with complex health needs while independent pharmacies do not necessarily have these things. Rep. Richard McGrew, R-Hot Springs, said he received several emails from constituents who ostensibly opposed HB 1150 but said they 'knew nothing about this' when he contacted them. He alleged that the emails came from lobbyists against HB 1150 who received his constituents' personal information from CVS, where they told him they receive prescription drugs. McGrew questioned Ellis about this 'breach of integrity,' and Ellis said she was not aware of this. Navitus Chief Pharmacy Officer Sharon Faust said Arkansas has been 'a frontrunner' on regulating prescription drug access and prices, but HB 1150 would be 'a step too far, a step further where you're actually limiting patient choice [and] reducing competition.' Vinson and Moore said PBMs routinely reimburse their affiliate pharmacies at a higher rate than their competitors, locally-owned independent pharmacies. This practice is outlawed in Arkansas by Act 1 and Act 3 of 2018, which became law after a special legislative session. Arkansas lawmakers have been attempting to regulate PBMs for the past decade, starting with Act 900 of 2015, which required PBMs to pay pharmacies at least as much as the national average of what drugstores pay wholesalers for drugs. Pharmacy benefit managers will have to pay Arkansas drugstores dispensing fees under new rule Despite this, pharmacies sent the Arkansas Insurance Department (AID) roughly 3,000 complaints in 2024, claiming PBMs either illegally paid them below this national average or paid them at or just above this amount, AID's general counsel told lawmakers last year. Independent pharmacists made similar claims in September, saying they were struggling to stay open in rural areas with limited healthcare resources. The Arkansas Legislative Council approved a rule in December to require PBMs to include dispensing fees in their reimbursements for prescription drugs. Removing PBM-affiliated pharmacies from the market would require the employee benefits division of the Arkansas government 'to reevaluate and restructure their pharmacy networks and implement new compliance measures,' according to an actuarial statement measuring the fiscal impact of HB 1150. 'There could be minor cost or saving[s] to the plan from excluding certain retail pharmacies from their network, such as CVS Caremark,' according to the statement. 'Such a change would require a significant number of EBD members to transfer their prescriptions to an in-network pharmacy and may reduce pharmacy network access.' SUPPORT: YOU MAKE OUR WORK POSSIBLE
