The PUTTcast

Independent pharmacies face immense pressure from Pharmacy Benefit Managers (PBMs), often confronting the impossible choice of losing money on a prescription or turning a patient away. In this episode of The PUTTcast, host Lauren Young sits down with Kris Rhea from Pharmacy Marketplace to discuss a game-changing solution to this "pharmacy spiral." They dive deep into the world of MAC appeals and underwater claims, revealing how new software helps pharmacy owners fight back and reclaim rightfully owed revenue. Whether you’re navigating new state statutes or tracking the PBM divestiture bill in Tennessee, this episode offers actionable insights and a powerful tool to strengthen your pharmacy's financial health while fueling the momentum for nationwide PBM reform.Music by cat_herding_diva | Production & Editing by Shannon Wightman-GirardKey TakeawaysThe Reality of the "Pharmacy Spiral": Understand the impossible decisions pharmacy owners face when dealing with underwater claims and how it impacts patient care.Automating MAC Appeals: Learn how Pharmacy Marketplace's software identifies eligible claims, generates compliant invoices, and tracks the appeal timeline from start to finish.State-Level PBM Reform: Discover which states are leading the charge in enforcing underwater payment statutes and how organized data empowers agencies to audit non-compliant PBMs.Escalating Rejections: Find out exactly what to do when a PBM rejects your appeal and how to involve your state's Department of Insurance or Attorney General.Advocacy in Action: Hear the latest updates on the Tennessee PBM divestiture bill and learn why independent pharmacies must actively participate to drive legislative change.ResourcesPharmacy Marketplace: Learn more about the MAC appeal tool and watch the demo video at pharmacymarketplace.comContact Kris Rhea: Reach out directly at [email protected] United for Truth and Transparency (PUTT): Join the fight for PBM reform and access more advocacy resources at truthrx.org

Passing legislation to regulate Pharmacy Benefit Managers (PBMs) is a monumental achievement, but it’s only half the battle. The real challenge—and the key to meaningful change—lies in strict, consistent enforcement. In this critical episode of PUTTcast, co-hosts Lauren Young and Monique Whitney sit down with a powerhouse panel of legal and pharmacy industry experts to dissect the current state of PBM law enforcement.Joined by special guests Mark Boesen of Boesen & Snow Law, Matt Seiler of NCPA, and Miguel Rodriguez of American Pharmacies, this episode takes a deep dive into the massive gap between existing PBM reform laws and on-the-ground compliance. Our panel breaks down the recent Federal Trade Commission (FTC) proposed settlement with Express Scripts, exposing what it means for independent pharmacies, and explores the recent alarming state audit findings that highlight a systemic failure by PBMs to follow state laws.Whether you’re a pharmacy owner, a legislator, or a healthcare advocate, this episode will shed light on why robust enforcement at both the state and federal levels is not just beneficial, but absolutely vital for the survival and longevity of the independent pharmacy industry.Music by cat_herding_diva | Production & Editing by Shannon Wightman-GirardKey TakeawaysThe Enforcement Gap: Having laws on the books means little without the resources and regulatory teeth to hold PBMs accountable for non-compliance.Government Role in PBM Oversight: The Express Scripts proposed settlement signals a shift in federal attention, with the goal of creating new precedents for how PBM practices are handled.State Audits Reveal Systemic Issues: Recent state-level audits have uncovered glaring patterns of PBMs ignoring statutory mandates, emphasizing the need for stricter state DOI and AG interventions.Future Enforcement Guidelines: Future PBM reforms must include built-in enforcement mechanisms, mandatory auditing, and severe penalties for violations.Benefits to the Industry: Proper enforcement ensures fair reimbursement rates, protects patient choice, and levels the playing field for independent pharmacies.Guest InformationMark Boesen, PharmD, JDFounding Partner, Boesen & Snow LawMark brings a unique dual perspective as both a pharmacist and a legal expert. He specializes in pharmacy law, regulatory compliance, and government affairs, fighting tirelessly for the rights of independent pharmacies.Matt Seiler, Esq.VP & General Counsel, National Community Pharmacists Association (NCPA)Matt leads the legal strategy for NCPA, advocating for the nation's independent community pharmacies. He is at the forefront of the battle against anti-competitive PBM practices at the federal level.Miguel Rodriguez, Esq.EVP & General Counsel, American PharmaciesMiguel is a leading voice in PBM litigation and legislative reform. Through American Pharmacies, he drives aggressive legal and advocacy strategies to ensure PBM transparency and accountability.Join the Fight for PBM Reform!If you found this episode valuable, please share it with your colleagues, state representatives, and fellow pharmacy advocates. Make sure to subscribe to PUTTcast on your favorite podcast platform so you never miss an update on the fight for fair pharmacy practices. For more resources and to join our mission, visit our website at TruthRx.org

Join hosts Lauren Young and Monique Whitney as they sit down with Alan Pannier, Chief Strategy Officer at SmithRx, to peel back the layers of the PBM industry. Their discussion explores the critical differences between traditional and pass-through PBM models and how the current system often obscures true costs from employers; shedding light on how innovative models like cost-plus pricing are reshaping the landscape, offering a fairer deal for both patients and independent pharmacies.Music by cat_herding_diva | Production & Editing by Shannon Wightman-GirardKey Topics:Pass-Through vs. Traditional PBMs: Breaking down the fundamental differences and why the distinction matters for transparency.How Traditional PBMs Game the System: A look at the tactics legacy PBMs use during the evaluation process to confuse employers and hide profit margins.The Benefits for Employers: Why switching to a pass-through model can lead to significant savings and clearer data for plan sponsors.The Cost-Plus Pharmacy Model: Explaining how this model works and its direct benefits for patient affordability and employer bottom lines.The Role of Independent Pharmacies: How integrating independent pharmacies into benefit plans can simultaneously decrease employer spend and increase pharmacy reimbursement.Market-Driven Reform: Why legislative action isn't enough—the market must actively demand better solutions to ensure PBM reform is effective.Resources & LinksSmithRx: Visit WebsitePharmacists United for Truth & Transparency (PUTT): TruthRx.orgSupport the Show: Become a PUTTcast Sponsor

In this episode of The PUTTcast, hosts Lauren Young and Monique Whitney are joined by special guest and pharmacy owner, Fair Jones, to explore key advocacy strategies for independent pharmacies striving for impactful PBM reform. They discuss how to effectively educate state and federal lawmakers, the critical role of follow-up communication, and the power of involving pharmacy patients in the process. Most importantly, they highlight how uniting independent pharmacies across states can strengthen their collective voice to push for enforceable PBM reform.Special Guest: FairRx founder & Mississippi pharmacy owner, Fair Jones, PharmDMusic by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Welcome back to part two of our special live crossover episode with PBM on the Rocks and The PUTTcast! In this conclusion to our live Summit day recording, we dive deeper into the critical issues facing the pharmacy industry today. The discussion picks back up on the front lines of PBM reform, exploring reform’s real-world impact on patients and independent pharmacies, then shifts to a powerful and often-debated topic: the case for unionization in pharmacy. But it's not all serious business. Maurice Shaw (The Dr of Comedy) and Shane Jerominsky (The Accidental Pharmacist) bring their unique perspectives as pharmacists and comedians to point out the comedic moments found in everyday pharmacy life - reminding us that laughter can be a powerful tool for coping with the immense pressures of the pharmacy profession.Special Guests: Maurice Shaw, PharmD, Shane Jerominsky, RPh, & Greg Reybold, APCI VP of Healthcare Policy & General CounselMusic by cat_herding_diva & JuliusH | Mixing by Andre Barden | Production & Editing by Shannon Wightman-Girard

Join co-hosts Jeremy Counts and Lauren Young as The PUTTcast teams up with the PBM on the Rocks Cocktail Crew for Part 1 of our special live crossover episode! We're breaking down the biggest moments from the 2025 PUTT Virtual Summit, and diving deep into the ever-changing world of PBM reform. This powerhouse discussion features an incredible lineup of guests who share their unique perspectives on the latest legislative battles, grassroots advocacy, and what independent pharmacy owners are facing on the front lines.Special Guest: Greg Reybold, VP of Healthcare Policy & General Counsel, APCIMusic by cat_herding_diva & JuliusH | Mixing by Andre Barden | Production & Editing by Shannon Wightman-Girard

In this month’s special episode of The PUTTcast, we’re gearing up for the highly anticipated PUTT Virtual Summit! Join host Lauren Young, PUTT Executive Director Monique Whitney, and special guest advocates Nikki Bryant and Rosemary C Smith as they explore the critical strategies independent pharmacies can use to amplify their voices and drive meaningful change. From building political connections to fostering trust within your community, listen in as they discuss how independent pharmacy owners can take charge of their advocacy efforts and make a lasting impact.Special Guests: Nikki Bryant, PharmD - Georgia independent pharmacy owner & Pharmacy Advocate; Rosemary C Smith, RPh - co-founder Kentucky Independent Pharmacists AllianceMusic by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

In this episode of The PUTTcast, discover how Louisiana legislators and healthcare advocates triumphed over corporate opposition to enact groundbreaking PBM reform with HB 264. Join host Lauren Young as she welcomes Louisiana State Representative Michael Echols and Louisiana Independent Pharmacies Association Director of Government Affairs Matthew Cross to discuss the collaborative fight that made this victory possible, and what it means for the future of fair pharmacy practices and patient care.Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Illinois has scored a monumental win for patients and pharmacies with the passage of HB 1697. This episode dives into the legislation’s groundbreaking PBM reform and unravels how, through bipartisan effort, it amplifies transparency, protects patients and pharmacies by securing fairer practices, and puts the needs of Illinois communities first. Join PUTTcast host Lauren Young and PUTT President Deborah Keaveny, with special guests Senator David Koehler, Representative Natalie Manley, IPhA Executive Director Garth Reynolds, and IPhA President David Bagot, as they explore the impacts of this victory and what it signals in the fight for healthcare justice.Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Fiduciary responsibility in the healthcare industry is a pressing issue, and pharmacy benefit managers (PBMs) are under increasing scrutiny. In this episode of The PUTTcast, we discuss how PBMs and their big insurance counterparts are using ERISA as a shield to avoid fiduciary accountability to employers. From the groundbreaking Rutledge SCOTUS decision to whistleblower revelations, we examine how the "fiduciary" concept is transforming the world of PBM reform and the transparency needed to make it happen. This episode is a wake-up call for employers and policymakers alike. Join PUTTcast host Lauren Young, co-host Chris Hobart, PharmD, and special guest Chris Deacon, JD, as they bring unparalleled insights into how regulatory enforcement, employer education, and data transparency are key battlegrounds in the critical fight for accountability.Episode Guest: Chris Deacon, JD, owner, VerSan Consulting, former NJ Deputy Attorney General, and past Director, NJ state health planMusic by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Breaking Down the Current Politics of Federal Prescription Drug ReformTired of legalese and political jargon surrounding federal prescription drug reform? This episode dives deep into President Trump’s recent healthcare reform Executive Order and what it really means for patients and their pharmacies. We’ll untangle topics like:The truth behind IRA drug price negotiations and how they could impact pharmacies and ultimately, patient access.  Why Medicare and Long Term Care pricing continues to be a battleground. How prescription drug rebates under current Safe Harbor laws create more problems than solutions.  The shocking facts behind drug pricing disparities and their real-world consequences.  The ongoing battle for PBM reform - and what could lie ahead.We’re joined by Mark Boesen, J.D., PharmD, of Boesen & Snow Law, who brings his expertise in pharmaceutical law, policy, and advocacy to help us decode the political language. Together, we discuss who could benefit and who could be harmed - because when it comes down to it, prescription drug reform and PBM reform are 2 sides of the same coin.Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

How Independent Pharmacies Can Amplify Their VoiceAt its core, PBM reform is not just a critical pharmacy issue - it’s a patient care issue. Join us for this insightful episode as we explore how independent pharmacies can use psychology, AI, and community-building strategies to craft testimony, fight misleading PBM narratives, and create a united voice for reform. Special Guest: Ken Patel, RPh, co-founder Arizona Independent Pharmacy CoalitionMusic by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Arkansas is fighting back against the abusive, anticompetitive practices of pharmacy benefit managers (PBMs). This episode dives into the systemic lawbreaking by PBMs and their exploitation of current laws - which comes at the expense of taxpayers, pharmacies, and Arkansas communities. This isn’t just about corporate greed—it’s about the lives of Arkansas families, patients, and healthcare providers. HB 1150 represents a critical effort to hold PBMs accountable and protect access to care for communities across the state.Special Guests:AR State Representative Jeremiah MooreAR State Senator Kim HammerAR State Representative Brandon AchorArkansas Pharmacists Association CEO John VinsonMusic by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Pharmacy Benefit Managers (PBMs) have long held disproportionate control over pharmacy reimbursement systems. But is change finally on the horizon? In this episode, we sit down with Congresswoman Diana Harshbarger to dissect the pressing issues surrounding PBM practices and discuss why now is the time to act. From federal legislation already in the works to the decisive importance of the first 100 days of 2025, Congresswoman Harshbarger walks us through her goals for actionable, enforceable PBM reform.Special Guest: Congresswoman Diana Harshbarger (R-TN)Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Don’t miss this insightful episode on why H.R. 9096 (The Pharmacists FIght Back Act) is essential for all communities. On the heels of last week’s successful press conference, PUTTcast host Lauren Young continues the conversation on why this legislation is a game-changer for pharmacies, small businesses, and patients, and provides practical advice on advocacy techniques that can help tip the balance in favor of this crucial legislation.If you find this episode valuable, please share it with your network and consider reaching out to your federal legislators to express your support for H.R. 9096: The Pharmacists Fight Back Act.Special Guests: Greg Reybold, APCI VP of Healthcare Policy & Monique Whitney, PUTT Executive DirectorUseful Links:Find Your Legislator: Find and contact elected officials | USAGovH.R. 9096 The Pharmacists Fight Back Act: https://www.congress.gov/bill/118th-congress/house-bill/9096Federal Employee Health Benefits Plan Drug Pricing, Variability, Specialty Drug Markups, & Steering Uncovered (APCI white paper): https://www.apcinet.com/Portals/0/leg-affairs/insights/apci-insights-002.pdfMusic by Oleg Fedak (https://pixabay.com/users/soulprodmusic-30064790)Production & Editing by Shannon Wightman-Girard

Welcome to our new short-form version of The PUTTcast! In our first episode, host Lauren Young dives into the intricacies of House Bill 9096, also known as the Pharmacists Fight Back Act. Joining her are distinguished guests—Congressman Jake Auchincloss (D-MA), Greg Reybold, Vice President of Healthcare Policy & General Counsel at the American Pharmacy Cooperative, Inc. (APCI), and Monique Whitney, PUTT Executive Director. Together, they unravel the essentials of this pivotal PBM reform bill and its implications on drug prices, patient access, the viability of independent pharmacies, and enforcement measures.Guests:Congressman Jake Auchincloss (D-MA): A prominent advocate for healthcare reform and sponsor of H.R. 9096 with Congresswoman Diana Harshbarger (R-TN), Congressman Auchincloss brings a wealth of knowledge and legislative experience to the discussion.Greg Reybold: Greg is the VP of Healthcare Policy & General Counsel at APCI (American Pharmacy Cooperative, Inc.). He brings extensive knowledge on healthcare policy and the intricacies of PBM regulations.Monique Whitney: Monique serves as the Executive Director of the nonprofit Pharmacists United for Truth & Transparency. As a vocal advocate for PBM reform, she offers a unique perspective on how HR 9096 will affect pharmacies and patients alikeFederal Employee Health Benefits Plan: Drug Pricing, Variability, Specialty Drug Markups, & Steering Uncovered (APCI white paper)H.R. 9096 The Pharmacists Fight Back ActMusic by Oleg Fedak (https://pixabay.com/users/soulprodmusic-30064790)Production & Editing by Shannon Wightman-Girard