Recent PBM Legislation

Jesse C. Dresser, Esq explains a recent piece of PBM legislation from North Dakota and its implications for specialty pharmacy at the NASP Annual Meeting in Washington, DC.

JD: So, there was a recent piece of legislation that was put out in North Dakota. Oddly, of all states, North Dakota has a very active session to put out a legislation that reigned in a lot of PBM practices. And it was really crafted with an eye towards steering clear of both ERISA preemption and Medicare preemption and what’s great about it is it gives a lot of rights to pharmacists and pharmacies that are active in that state to basically to take the law into their own hands and do something about it. A lot of the other states’ laws don’t have a private right of action or don’t have specific tools that are available to pharmacies or pharmacists to take action on their own. What’s really great about North Dakota’s law is that it does, and the other thing that’s great about it is it actually withstood a couple challenges by PCMA, the PBM lobbying group, [who] came out and actually filed a lawsuit to try to prevent this law from going into effect and lost. So, it serves as a great roadmap for other states that are looking to take action that reigns in the practices of PBMs, brings them to some form of regulation, but more than anything else, gives the affected parties tools to deal with them. Whether it’s the pharmacies, whether it’s the patients, that’s kind of the roadmap that we really look to. And we’ve counseled pharmacies both in the North Dakota space and also pharmacies that are working with their local legislators and coming up with tools and options that are available.