PBM Reform Efforts Stalled in Congress | PBM Reform episode artwork

EPISODE · Oct 19, 2023 · 31 MIN

PBM Reform Efforts Stalled in Congress | PBM Reform

from Pharmacy Podcast Network · host Pharmacy Podcast Network

In the Senate, there are 3 committees that have advanced legislation on PBM reforms, with leadership supporting a floor vote before the end of 2023. In the House, a consolidated bill was released in September and although there are plans for a full House vote, they are stalled due to the current issues in Congress. There are 3 key jurisdictions and proposed plans of the Senate that focused on in the session: The Finance Committee, including Medicare and Medicaid; the Health, Education, Labor, and Pension (HELP) Committee, including plans that regulate under the Employee Retirement and Income Security Act and the Affordability Care Act; and the Commerce Committee, including interstate commerce and the Federal Trade Commission (FTC). The Finance Committee Package includes the prohibition of spread pricing in Part D for Medicaid and Medicare managed care. The Part D rebates must also be passed through the prescription drug plan sponsors, used to lower the costs for prescription drugs with a 100% pass-through in Medicaid managed care, according to Andel. Reference: https://www.pharmacytimes.com/view/amcp-session-provides-updates-on-pbm-reform-efforts-currently-stalled-in-congress  Guests Erich Cushey PharmD - Pharmacy Owner  Curtis Pharmacy  Seema Kazmi, PharmD  Seema currently serves on the Board of the Pennsylvania Pharmacists Association as a Practice Setting Director for pharmacists in Managed Care, Pharmaceutical Industry, Government Affairs and other practice settings. Dr. Kazmi has been a pharmacist for over 17 years and started her pharmacy career as an overnight community pharmacist in Levittown, Pa.  Dr. Kazmi is a graduate of Philadelphia College of Pharmacy and is a licensed pharmacist in six states, serving in leadership and management roles in managed care, pharmaceutical industry, community pharmacy, long-term care, and public service. Seema Kazmi, PharmD currently serves on the Board of the Pennsylvania Pharmacists Association as a Practice Setting Director for pharmacists in Managed Care, Pharmaceutical Industry, Government Affairs and other practice settings. 

In the Senate, there are 3 committees that have advanced legislation on PBM reforms, with leadership supporting a floor vote before the end of 2023. In the House, a consolidated bill was released in September and although there are plans for a full House vote, they are stalled due to the current issues in Congress.There are 3 key jurisdictions and proposed plans of the Senate that focused on in the session: The Finance Committee, including Medicare and Medicaid; the Health, Education, Labor, and Pension (HELP) Committee, including plans that regulate under the Employee Retirement and Income Security Act and the Affordability Care Act; and the Commerce Committee, including interstate commerce and the Federal Trade Commission (FTC). The Finance Committee Package includes the prohibition of spread pricing in Part D for Medicaid and Medicare managed care. The Part D rebates must also be passed through the prescription drug plan sponsors, used to lower the costs for prescription drugs with a 100% pass-through in Medicaid managed care, according to Andel.Reference:https://www.pharmacytimes.com/view/amcp-session-provides-updates-on-pbm-reform-efforts-currently-stalled-in-congress GuestsErich Cushey PharmD - Pharmacy Owner Curtis Pharmacy Seema Kazmi, PharmD Seema currently serves on the Board of the Pennsylvania Pharmacists Association as a Practice Setting Director for pharmacists in Managed Care, Pharmaceutical Industry, Government Affairs and other practice settings. Dr. Kazmi has been a pharmacist for over 17 years and started her pharmacy career as an overnight community pharmacist in Levittown, Pa.  Dr. Kazmi is a graduate of Philadelphia College of Pharmacy and is a licensed pharmacist in six states, serving in leadership and management roles in managed care, pharmaceutical industry, community pharmacy, long-term care, and public service. Seema Kazmi, PharmD currently serves on the Board of the Pennsylvania Pharmacists Association as a Practice Setting Director for pharmacists in Managed Care, Pharmaceutical Industry, Government Affairs and other practice settings.

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PBM Reform Efforts Stalled in Congress | PBM Reform

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This episode was published on October 19, 2023.

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In the Senate, there are 3 committees that have advanced legislation on PBM reforms, with leadership supporting a floor vote before the end of 2023. In the House, a consolidated bill was released in September and although there are plans for a full...

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