Latest news with #SB252
Yahoo
10-04-2025
- Business
- Yahoo
‘A lifeline': Alabama legislators pass bill locally-owned pharmacies say will keep them in business
HUNTSVILLE, Ala. (WHNT) — Locally owned Alabama pharmacies have been closing their doors at a rapid rate, but a bill that passed the state legislature Tuesday will change how they are reimbursed, aiming to keep more independent pharmacies open. Huntsville-based Star Discount Pharmacy Director Trent McLemore said he would not have expected to see this day six months ago, and he believes this bill will create a more fair system. Congressman Mike Rogers says Space Command relocation announcement could come in April 'It is literally a lifeline for independent pharmacies, for small businesses, which is what really matters,' McLemore said. He said local pharmacies have been getting paid less than their larger, corporate counterparts. SB 252, called the Community Pharmacy Relief Act, will put new regulations on Pharmacy Benefit Managers (PBMs). PBMs are the middlemen who work between pharmacies and insurance companies. They decide how much money a pharmacy will be reimbursed for filling a prescription. The legislation directs PBMs to take 100% of the rebate money they get from drug makers in connection with Alabama contracts and pay the money to Alabama health insurance providers. The money will be used to make sure independent pharmacists are paid a $10.64 dispensing fee. The measure still needs Gov. Kay Ivey's signature to become said that while pharmacies will be paid more, patients will not see cost increases. 'Your co-pays will not go up when this starts,' McLemore said. 'Your premiums won't go up, and ultimately, you'll have more options as soon as the governor signs this.' Patients should now pay the same co-pay at any in-network pharmacy. 'No longer will it be, 'Well, I'm sorry. We can only fill here twice, and you have to get a mail order, or I can only fill for 30 days versus 90 days, or the co-pay is way higher at an independent,'' McLemore said. 'Those will all be on an equal playing field.' McLemore said that when the cost of getting a prescription filled is not a determining factor anymore, he believes competition will be driven by customer service. 'It makes it about patient care instead of about dollars again,' McLemore said. Letters addressed to Alabama House members contained pornographic images: ALEA He said the passage of the bill is a win for David against Goliath. 'Being able to know that we won't get paid below our cost is a lifesaving grace for a lot of independent pharmacies,' McLemore said. More than 100 Alabama pharmacies have closed in the past four years, state figures show. The Alabama Legislature has also called for a multi-year study looking into how PBMs are operating in the state and identify any practices that are decreasing positive competition between pharmacies. McLemore said he hopes the study will inspire more legislation down the line, like expanding access to specialty pharmacy drugs. 'Specialty pharmacy accounts for about half of PBM profits right now,' McLemore said. 'Those are your very expensive items. These are the drugs you see on TV commercials, and they cost tens of thousands of dollars.' Specialty pharmacy drugs are excluded from the current legislation. Pharmacies will begin receiving reimbursements on October 1. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
08-04-2025
- Business
- Yahoo
Alabama House passes bill regulating pharmacy benefit managers
Rep. Phillip Rigsby, R-Huntsville, speaking on the floor of the Alabama House of Representatives in the Alabama State House in Montgomery, Alabama, on April 8, 2025. Rigsby, an independent pharmacy owner, carried "Community Pharmacy Relief Act", sponsored by Sen. Sen. Bill Beasley, D-Clayton, which passed the House unanimously. (Anna Barrett/Alabama Reflector) The Alabama House of Representatives on Tuesday unanimously passed legislation that creates new regulations on reimbursements and fees pharmacy benefit managers (PBMs) charge to pharmacies. SB 252, sponsored by Sen. Bill Beasley, D-Clayton, and called the 'Community Pharmacy Relief Act,' seeks to address concerns from independent pharmacies over reimbursement rates and business practices that critics say have driven many out of business. PBMs act as a 'middle-man' between health insurers, pharmacies and drug manufacturers. They negotiate drug prices, determine reimbursement rates for pharmacies and manage prescription drug benefits. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Critics accuse PBMs of using their position to impose unfair fees and steer patients toward PBM-owned pharmacies. PBMs are also accused of keeping manufacturer rebates for themselves instead of passing the savings along to consumers. Rep. Phillip Rigsby, R-Huntsville, an independent pharmacy owner who carried the legislation in the House, said after the bill passed that the process was hard, but that he knew he needed to continue on for the local pharmacies across the state. 'There have been many ups and downs in this journey, and there were days I wanted to throw in the towel, but I realized that my flesh was telling me to quit,' Rigsby said. 'Thanks be to God. When I felt defeated, that's when my faith reminded me.' Rep. Mark Gidley, R-Hokes Bluff, said the legislation is very important for family-owned pharmacies across the state. According to ABC33/40, 300 of Alabama's 800 independent pharmacies have closed across the state in the last six years. 'We have pharmacies that are closing all across the state. My understanding is about 10 since the first of the year,' Gidley said. 'The loss of local pharmacies is a terrible detriment to the health care of our people, especially in the rural areas. This can't happen.' The bill would impose new restrictions on PBMs, including a prohibition on reimbursing independent pharmacies at rates lower than those paid by the Alabama Medicaid Agency. It would also ban PBMs from charging certain fees to pharmacies, require them to pass on 100% of manufacturer rebates to health plans and prevent them from blocking pharmacists from disclosing lower-cost alternatives to patients. The House unanimously passed an amendment from Rep. Joe Lovvorn, R-Auburn, that would allow pharmacies to negotiate with the PBMs to keep a part of rebates used for administrative reasons. 'If I'm a private business and have the right to negotiate with a PBM, that if I want to take part of those rebates from those drugs that are offered, I can either receive those rebates or I can negotiate to be part of the administrative fee,' Lovvorn said. The bill goes to the Senate for concurrence or a conference committee. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
03-04-2025
- Business
- Yahoo
Bill setting $10 dispensing fee for pharmacists moves forward in Alabama Legislature
HUNTSVILLE, Ala. (WHNT) — The Alabama Legislature moved another step closer to approving a measure to pay pharmacists a $10 dispensing fee for each prescription handled. Supporters point to problems with the current reimbursement system, which they argue has led to the closure of more than 100 pharmacies in Alabama over the past four years. Local dealership weighs in on how auto tariffs could impact prices The Alabama House Insurance Committee held a hearing on Senate Bill 252 on Wednesday and voted to send the bill to the full House of Representatives for consideration. In addition to directing pharmacists be paid a $10.64 dispensing fee, the measure would provide some regulation over Pharmacy Benefit Managers, or PBMs, that operate in the state. The measure has already been approved by the Alabama Senate. The $10.64 dispensing fee is the rate the Alabama Medicaid program pays pharmacists for dispensing drugs. Pharmacy Benefit Managers administer prescription drug plans for health care providers. Alabama pharmacists argued before the Insurance Committee Wednesday that they pay a fixed price for the prescription drugs they dispense and get a fixed fee for dispensing that drug from PBMs. However, they contend that in recent years, the reimbursement levels have fallen to the point where they are being paid less by the PBMs to distribute that drug than the cost of distributing it. Boaz pharmacist Ann Noojin addressed the House Insurance Committee during the public hearing Wednesday. She was one of six people the committee heard from; three spoke in favor of SB 252, and three spoke in opposition. 'We're drowning. We buy medications at a set cost, we dispense them at a set reimbursement,' said Noojin, who said she followed her father in the pharmacy business and that her daughter has plans to be a pharmacist as well. 'Pharmacy owners haven't suddenly lost their skills to run a successful business, it's been taken away from us. Senate Bill 252 is a win for Alabama consumers, employers and pharmacy. A practical bill to provide for a fair and proven payment to pharmacies, choice and access for patients and transparency for employers.' But leaders of business groups, including the Business Council of Alabama, expressed concern that the fees paid to pharmacists would be passed on to business owners. 'Increasing a cost on a business, I don't know about y'all, but most businesses don't absorb that cost,' John Barganier, CEO of Manufacture Alabama, told the committee. 'They pass it down to their customer. In this case, with a new dispensing fee being proposed. PBMS are sophisticated organizations, they have a lot of resources. And at the end of the day, it's our concern they will ultimately pass this increased cost down to their customers, which happen to be employers that provide employer-sponsored health care benefits.' Supporters point to the bill's language. PBMs get paid a rebate by drug manufacturers to be included on an insurance plan's approved drug list. The bill directs that 100 percent of the rebate money PBMS get from drug manufacturers should be given to health plan providers. The bill's supporters say a portion of that money will cover the dispensing fees that SB 252 would pay to pharmacists. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
21-03-2025
- Business
- Yahoo
Alabama Senate passes bill regulating pharmacy benefit managers
Sen. Billy Beasley, D-Clayton, (right) speaks with Sen. Keith Kelley, R-Anniston on the floor of the Alabama Senate on March 19, 2025 at the Alabama Statehouse in Montgomery, Alabama. (Brian Lyman/Alabama Reflector) The Alabama Senate Thursday passed a bill creating new regulations on reimbursements and fees pharmacy benefit managers (PBMs) charge to pharmacies. SB 252, sponsored by Sen. Bill Beasley, D-Clayton and called the 'Community Pharmacy Relief Act,' seeks to address concerns from independent pharmacies over reimbursement rates and business practices that critics say have driven many out of business. 'We're losing almost one drugstore per week, going out of business because they are paid such a small amount of money from the PBM industry to fill prescriptions for their patients at their drugstore,' Beasley, a retired pharmacist, said on the Senate floor. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX PBMs act as a 'middle-man' between health insurers, pharmacies and drug manufacturers. They negotiate drug prices, determine reimbursement rates for pharmacies and manage prescription drug benefits. Critics accuse PBMs have used their position to impose unfair fees and steer patients toward PBM-owned pharmacies. PBMs are also accused of keeping manufacturer rebates for themselves instead of passing the savings along to consumers. The bill, which passed in a 32-0 vote with one abstention, would impose new restrictions on PBMs, including a prohibition on reimbursing independent pharmacies at rates lower than those paid by the Alabama Medicaid Agency. It would also ban PBMs from charging certain fees to pharmacies, require them to pass on 100% of manufacturer rebates to health plans and prevent them from blocking pharmacists from disclosing lower-cost alternatives to patients. The bill faced intense but cordial debate on the Senate floor, with supporters of the bill saying PBMs are currently straining independent pharmacies. Beasley, pointing to pharmacy closures, criticized the PBM industry for what he described as unfair reimbursement practices. 'The PBM industry owns the mail-order pharmacies. They control the contract that the drug solos agree to,' Beasley said, adding that 'over the last 40 years, and they always say, 'if you let me be your manager, we'll save you money on your expenditures on prescription drugs.' Well, Senators, it hasn't happened.' Sen. Chris Elliott, R-Daphne, introduced an amendment that would have delayed the reimbursement provisions until January 2026 to allow businesses time to adjust. 'We have friends in the business community, both on the pharmacy side and on the employer and employee side. And what this does is simply move again the effective date … so it gives them time to work through their contracts and enter into new contracts,' Elliot said. The amendment failed after Sen. Andrew Jones, R-Centre, opposed the delay, saying that pharmacies needed relief immediately. After further discussion, lawmakers settled on an October 1 effective date as a compromise. After the vote, senators from both parties said the bill was a significant step in addressing rising prescription drug costs and protecting local pharmacies. ' This is something that has been worked on for years to try to rectify this situation, and we've just finally gotten to the point it has been bipartisan. These two gentlemen have practiced pharmacy in the state for a long time. They understand the process,' Sen. Larry Stutts, R-Tuscumbia, said after the Senate adjourned. Jones made a point to say that the bill's provisions would not increase consumer costs. 'The actual acquisition cost of drug plus the reimbursement, which is based on Medicaid, that cannot be passed on to the consumer,' Jones said. 'And anything to the contrary is just a scare tactic.' The bill now moves to the House of Representatives for consideration. SUPPORT: YOU MAKE OUR WORK POSSIBLE
