March 20, 2023
Payers | Tea Leaves
  • A group of House lawmakers is hoping to outlaw the use of spread pricing by pharmacy benefit managers (PBMs) in the Medicaid program. The Drug Transparency in Medicaid Act, reintroduced Friday, is the latest PBM reform bill launched by this Congress. The bipartisan bill would ban spread pricing in Medicaid managed care plans, a tactic where PBMs can charge health plans more for a drug than what they reimburse the pharmacy for. The legislation would also require any pharmacy reimbursements for Medicaid managed care programs to be at a rate for the pharmacy’s average acquisition costs of the product. (Article here)