Mississippi pharmacists want lawmakers in their state to force an end to limits on where people covered by certain insurance plans can get prescriptions filled. But, lobbyists for some pharmacy benefit managers say the state can’t legally regulate certain insurance plans because they’re covered by federal law. The opposing sides appeared at a House Insurance Committee hearing called by Chairman Gary Chism. Rep. Chism proposes allowing local pharmacies to match mail-order discounts given by benefit managers. Neither insurers nor independent pharmacists like this approach and opposed it.
Pharmacists say too many drug plans are forcing customers to use particular mail order and retail pharmacies or else pay more. They say that if their stores can meet the terms of the drug plan, they should be able to participate, too. The pharmacists say they just want an “even playing field for everybody involved.” The committee didn’t vote and it’s unclear if any proposal will have enough support to get through the legislature. Large pharmacy chains and drug plans say a 1996 law meant to aid independent drug stores is sufficient. They say pharmacists should complain to the Insurance Department if they see violations.
Allen Horn, a lobbyist for CVS Caremark, said his company is just implementing terms of contracts desired by clients. CVS has both retail pharmacies and a mail-order business. Horne said that some plans where employers self-insure under federal law are beyond the reach of Mississippi insurance officials. He told the committee that “[t]hose are health plans that the Department of Insurance has no authority over.” Rep. Chism urged pharmacists to complain to the Insurance Department, which says it hasn’t heard from anyone claiming the current 1996 law is being violated. He believes that’s because the pharmacists and the consumers haven’t known where to complain.
The Mississippi Independent Pharmacies Association wants the state Board of Pharmacy to regulate drug plans. Executive Director Robert Dozier said it’s possible the board might be able to assert more authority over drug plans, citing a 2011 law that gives the board permission to regulate the benefit managers. It was reported that Mississippi is the only state with such a law. If that’s true, other states may need to look into whether a similar laws should be passed.
Source: Insurance Journal
Contact us today for a free legal consultation with an experienced attorney.
Fields marked *may be required for submission.
If you would like to subscribe to the Jere Beasley Report digital edition, simply visit our Subscriptions page and provide the necessary information or call us at 800-898-2034.
Attorney Advertising - Prior results do not guarantee a similar outcome.