Sen. Williams: Consideration of further regulation on Pharmacy Benefit Managers

Greetings District 36. This week, most standing Committees finished their public hearings for this legislative session.

The Legislature will now begin full day debate of bills that have advanced out of the standing Committees. The Banking, Commerce, and Insurance Committee ended its public hearing schedule with a hearing on LB270 and LB375, both of which propose to further regulate Pharmacy Benefit Managers, more commonly called PBMs.

Pharmacy Benefit Managers are companies that serve as “middlemen” between pharmaceutical companies and health insurance companies and were originally formed to reduce administrative costs incurred by health insurers. Over time, as the major health insurance companies purchased or created their own PBMs, an increasing number of complaints have been brought to the Legislature by local pharmacies, health care providers, and consumers related to evolving PBM business practices. As health care costs continue to rise, and with 30 percent of health care costs attributed to the cost of pharmaceutical drugs, it is important that the Legislature address these complaints.

Last session the Legislature prohibited PBMs from penalizing local pharmacies for sharing information regarding the cost, price, or copayment of a prescription drug with an insured individual. In addition, the Legislature prohibited PBMs from charging an individual for a drug in an amount that exceeds the covered individual’s copayment, deductible or coinsurance, or that exceeds what a drug would cost if the individual were to pay for it in cash. This year, the Legislature will consider further regulations of PBMs through auditing requirements, maximum allowable costs, spread pricing, specialty pharmacies and drugs, drug coupons and rebates.

I would also like to congratulate all winter sport teams across District 36 for their hard work and dedication in their respective sports. A special congratulations to the Broken Bow and Pleasanton Girls Basketball Teams on reaching the Nebraska State Basketball Tournament. Good luck!

As always, feel free to contact me anytime at (402) 471-2642 or mwilliams@leg.ne.gov. Thanks again for your continued support.