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The efforts of pharmacy organizers in Chambers County paid off when legislation regulating and limiting the control of Pharmacy Benefits Managers (PBMs) passed through the state Senate earlier this month. The Senate Bill 252 is now heading to the House for voting.

According to Hood’s Pharmacy’s Kirsten Hood, SB 252 or “The Community Pharmacy Relief Act,” has had bipartisan support and passed the vote 32-0. 

SB 252 is a combined legislation from SB 93 and SB 99, which had 22 co-sponsors in the state Senate. The bills aimed to protect locally owned pharmacies by creating oversight for PBMs by the Department of Insurance and authorize pharmacies and health insurance plans to bring a cause of action against PBMs for violations. 

Hood and Valley Pharmacy’s Craig Moore were among the first in the state to begin organizing against the detrimental effects that intermediary companies, PBMs, have had on local pharmacies. Their alliance represents the interest of over 100 local Alabama pharmacies. 

In February, white coats lined the halls of the Alabama State House as local pharmacists showed out at the legislative session in support of the bill. With the threat of closure looming over small town pharmacies, Moore said it wasn’t difficult to gain traction. 

PBMs serve as middlemen between health insurance plans and their network pharmacies. They decide how much prescriptions cost, what drugs are and aren’t covered and how much pharmacies are paid for the prescriptions.

They also deal with drug manufacturers to “negotiate discounts or rebates on drug prices and may also be affiliated with particular pharmacies that also participate in the network,” according to SB 99.

Hood said that similar legislation has been passed in states like West Virginia.

“The West Virginia insurance commissioner has said that their legislation has seen a reduction in patient premiums already,” Hood said. “…The goal was to help us all, but then also to help patients. And so we were hopeful that all the patients in Alabama will see similar positive results.”

The Senate Bill 252 would:

Prohibit pharmacy benefits managers from reimbursing independent pharmacies less than the amount paid by the Alabama Medicaid Agency to pharmacies for prescription drugs for a period of two years.

prohibit pharmacy benefits managers from charging pharmacies or pharmacists miscellaneous fees related to network participation and claims processing, and from charging other fees that reduce reimbursement or increase out-of-pocket charges to health plan beneficiaries.

Prohibit PBMs from barring disclosure of information by pharmacists to consumers about drug costs and alternative drugs for treatment.

Require PBMs to pass on 100 percent of rebates received from drug manufacturers to the health benefit plans for which they provide services.

Specify that the Commissioner of Insurance shall enforce violations by a pharmacy benefits manager, including those committed during an audit of a pharmacy under the Pharmacy Audit Integrity Act, and would provide a civil penalty.

Provide a civil action for pharmacists, pharmacies, and insurance beneficiaries for injuries due to violations by a pharmacy benefits manager.

To review the full Senate Bill 252 legislation, visit https://alison.legislature.state.al.us/bill-search. 

Moving forward, Hood encouraged the community to reach out to their local pharmacy if they have questions about the legislation.

“I feel like the independent pharmacies have proven themselves to be trustworthy for communities and to lawmakers, so just if they see anything on social media or read anything that they have any questions about, please continue to call or come by instead of reposting or making assumptions from people who have not proven themselves quite as trustworthy.” Hood said.