May 2025 Pharmacy Policy

Arkansas Law Bans PBM-Owned Pharmacies

On April 16, Arkansas Gov Sarah Huckabee Sanders signed into law House Bill 1150, which bans state permits to pharmacies owned by pharmacy benefit managers (PBMs). The law will take effect January 1, 2026.¹

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Supporters of this bill say it will help end PBM tactics that have long been seen as unfair to pharmacies, such as patient steering, below-cost reimbursements, and punitive audit practices. The Arkansas Pharmacists Association played a key role in supporting this legislation throughout its journey to the governor’s desk, finding support in both chambers of the state legislature.²

“[House Bill] 1150 is a structural change that gets to the heart of the problem—the conflicts of interest inherent in vertical integration that PBMs have been manipulating to the detriment of patients, taxpayers, and pharmacies,” Anne Cassity, senior vice president of government affairs for the National Community Pharmacists Association, said in a news release. “We applaud [House Bill] 1150 and are eager to see its provisions implemented in Arkansas and, ideally, throughout the country.”²

Similar legislation has been introduced on the federal level and in other states, highlighting the ongoing push for PBM reform throughout the country.²

Executive Order Directs Leaders of HHS, CMS to Take Action on Drug Costs

On April 15, President Donald Trump signed an executive order directing the leaders of the US Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), and the Office of Management and Budget to take meaningful steps to lower drug costs.¹

The order outlines 13 directives, instructing authorities to investigate factors that influence drug costs and present possible solutions to the president. According to a statement from Trump, this order is intended to improve upon the Inflation Reduction Act by instructing HHS to issue guidance that improves transparency in Medicare drug price negotiations and prioritizes high-cost drugs.¹

In addition to addressing small molecule drugs, the order notes that biosimilars can generate significant savings of up to $181 billion in the next 5 years. The directives in the order include encouraging the development of generic and biosimilar alternatives to high-cost brand-name treatments.¹

Additionally, one of the directives orders the secretary of the Department of Labor to “propose regulations…to improve employer health plan fiduciary transparency into the direct and indirect compensation received by pharmacy benefit managers.”¹

Equitable Community Access to Pharmacist Services Act Aims to Ensure Patient Access

Various pharmacy organizations are continuing to support the Equitable Community Access to Pharmacist Services (ECAPS) Act, which has garnered significant bipartisan support.^1,2

The ECAPS Act is a bipartisan legislative effort intended to permanently expand Medicare coverage to include various clinical services provided by pharmacists. These services, temporarily authorized during the COVID-19 pandemic, include testing, vaccination, and treatment for common illnesses such as COVID-19, influenza, and strep throat. The core of the ECAPS Act is to establish a direct reimbursement mechanism under Medicare Part B for these services, ensuring continued access for Medicare beneficiaries.²

The ECAPS Act has been introduced in both the House of Representatives (HR 1770) and the Senate (S 2477) during the 18th Congress (2023-2024). As of December 17, 2024, the House bill was referred to the Subcommittee on Health. Both bills have significant bipartisan support, with more than 100 cosponsors in the House of Representatives and approximately 2 dozen in the Senate. Despite this support, the ECAPS Act is still under consideration and has not yet been passed, although some of its language was nearly passed as part of an end-of-year omnibus package in 2024.^1-3