Alexandria, Va. April 3, 2014
- The National Community Pharmacists Association (NCPA) commends Washington State Governor Jay Inslee (D) for signing ESSB 6137 into law. This legislation is modeled after a similar law that was passed in Oregon in 2013. ESSB 6137 applies reasonable standards to how Pharmacy Benefit Managers (PBMs) audit community pharmacies; provides increased transparency into generic prescription drug reimbursement; and ensures that PBM administrators of prescription drug claims are registered within the state.
The legislation passed both houses of the legislature with overwhelming support.
"NCPA commends the hard work of the Washington State Pharmacy Association (WSPA) and the local stakeholders who helped guide this comprehensive bill through the legislature. NCPA was proud to work with all those involved in this effort including the WSPA, NACDS and local pharmacists," said NCPA CEO B. Douglas Hoey, MBA, RPh. "Passage of this legislation is further evidence that when legislators take a close look at PBM practices, they come to the conclusion that a legislative remedy is required."
With Governor Inslee's signature, Washington becomes the 30th state to address abusive pharmacy audits. The bill provides mechanisms to ensure pharmacy audits are focused on their intended purpose of combatting fraud, waste and abuse. The bill also implements safeguards to prevent audits from being utilized as a PBM profit-making scheme by forbidding recoupments in the cases of minor clerical or typographical errors.
ESSB 6137 provides pharmacists with basic insight into how they will be reimbursed for dispensing generic medications and provides some transparency into how a product is designated for a maximum allowable cost (MAC) list. The legislation requires PBMs to update their MAC list on a regular basis and reimburse pharmacies based on current market conditions
and acquisition costs. Washington is the sixth state to address this issue.
Finally, the bill establishes a modicum of regulatory oversight of PBMs by requiring PBMs to register with Washington's Department of Revenue.
"NCPA applauds Governor Inslee and the legislature for enacting this common sense legislation, and encourages other states who may consider PBM legislation in the future to look to the Pacific Northwest as a model," Hoey concluded.