Pharmacists Praise Enactment of Texas Bills Providing for Fair Pharmacy Audits and Pricing Transparency

Published Online: Monday, June 17, 2013

Alexandria, Va. June 17, 2013 - The National Community Pharmacists Association (NCPA) commends Governor Rick Perry(R) for signing into law two significant pieces of legislation in support of Texas small business independent community pharmacies: HB 1358, legislation that provides common-sense standards to pharmacy audits conducted by multi-billion dollar middlemen known as pharmacy benefit managers (PBMs), and SB 1106, which provides transparency in generic drug maximum allowable costs (MACs) for Medicaid plans.

With the Governor's signature, Texas becomes the 25th state to enact legislation intended to focus pharmacy audits on uncovering fraud and the fourth to enact MAC transparency. Currently, the audit process is frequently abused by middlemen generating profits by recouping payments over technical issues that have no bearing on whether the proper patient received the proper medication as prescribed by a doctor, for the correct cost, while pharmacies are presented take it or leave it contracts with vague language on generic drug reimbursements.

"NCPA is extremely grateful for all of the hard work of everyone who brought this legislation to fruition, especially Michael Wright, executive director of the Texas Pharmacy Business Council (TPBC) for his stellar leadership," said B. Douglas Hoey, RPh, MBA and NCPA CEO, "With Governor Perry's signature, half of all states have recognized the challenges independent pharmacies face with PBM audits and the need for statutory standards. Additionally, Texas becomes the fourth state to ensure independent pharmacies receive some predictability in how they will be reimbursed for generic medications. For independent pharmacies this of great importance since 80% of the medications they dispense are generics."

Hoey continued, "There are over 1,500 small business independent community pharmacies in the state of Texas. These small businesses provide local jobs and add to the tax bases of their communities. Statistics show that for every dollar spent at a local small business, 68 cents of that remains in the community. This legislation ensures these revenues remain in the community and are not siphoned off by large out-of-state entities."

Michael Wright added, "Thanks to the hard work of our pharmacists here in Texas, fair audit reform and MAC transparency have been enacted. This legislation allows our pharmacists to focus more attention on patient health and obtaining positive outcomes on their behalf rather than justifying minor clerical errors to the PBMs. This also provides a modicum of transparency in how pharmacies will be reimbursed for dispensing lower cost generic medications. We are thankful to the legislature and to Governor Perry for recognizing the necessity of these measures and enacting these common sense reforms for small business independent pharmacies that many of our fellow Texans rely on for their health care needs."

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