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Rep. Lipps Announces Re-Introduction of Pharmacy Benefit Manager Bill

Plans to Continue Combatting Prescription Drug Prices
February 11, 2019
P. Scott Lipps News

COLUMBUS—State Representative Scott Lipps (R-Franklin) today announced that he has re-introduced House Bill 479 from the 132nd General Assembly, with Representative West (D-Canton). This bill will expand access to affordable prescription drugs by increasing price transparency and ensuring a fair payment process for pharmacies and patients.

The bill seeks to reduce the administrative burden placed on pharmacists by Pharmacy Benefit Managers (PBMs), which act as third-party intermediaries between pharmacies and health insurers. By requiring that patients are informed of the most affordable payment option for their prescriptions, PBMs will be unable to direct the pharmacy to charge the patient more than the cash price of a drug. By inflating this cost to patients, PBMs take a portion of the patient’s co-pay, driving up costs.

The bill also prohibits PBMs from including a provision in their contract with a pharmacy that forbids pharmacists from informing patients of the cheapest method to purchase their prescriptions. For example, if a copayment is more than the price of a drug without insurance, the pharmacist must inform the patient. The patient may then decide to pay less for their prescription without going through their insurance.

“We remain determined to expose and stop the malicious and greedy practices utilized by PBM’s to hurt our citizens and Ohio’s budget. We are excited to reintroduce House Bill 479, from the 132nd General Assembly, which eliminates gag rules and clawbacks. Governor DeWine and his administration are keenly aware of the millions of dollars PBM’s have siphoned out of Ohio. It is time for all of us, including the Legislature, Managed Care Organizations (MCO’s) and Medicaid to work together and FIX this,” said Rep. Lipps.

The Ohio Department of Insurance and Ohio Department of Medicaid have both already implemented rules that effectively accomplish the goals of this bill. However, passing this legislation still remains a priority to codify these changes and make them permanent and

House Bill 479 passed the House unanimously in the 132nd General Assembly.