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    New laws increase transparency, accountability of pharmacy benefit managers

    By Bill O’Boyle [email protected],

    22 hours ago
    https://img.particlenews.com/image.php?url=23T0LY_0ueQqo0d00
    Shapiro

    WILKES-BARRE — Gov. Josh Shapiro this week joined Pennsylvania Insurance Commissioner Michael Humphreys, members of the General Assembly and local pharmacists to highlight the bipartisan reforms that increased oversight of pharmacy benefit managers (PBMs) — the hidden “middlemen” of the pharmaceutical supply chain who largely go unchecked and unregulated as they negotiate the price of prescription drugs, passing the costs down to Pennsylvanians.

    Last week, Gov. Shapiro signed House Bill (HB) 1993 into law, providing stronger protections for commercially insured patients in the Commonwealth and increasing regulatory oversight of PBMs.

    “For too long, we’ve had PBMs — these unseen middlemen — manipulating and profiting off of the pharmaceutical system at the expense of consumers and our community pharmacies,” Shapiro said. “They’ve been failing to significantly reduce prices, unilaterally changing the terms of contracts with pharmacies, and picking and choosing who wins and who loses. These predatory practices have been screwing over the good people of Pennsylvania, forcing dozens of local independent pharmacies to close in the process. But my Administration and lawmakers from both parties came together to do something about it and put a stop to PBMs’ unsavory practices. We’ve shown that we can work together and get stuff done, giving Pennsylvanians transparency and more peace of mind.”

    Charged with negotiating the price of prescription drugs between health insurance companies and drug manufacturers, PBMs also establish pharmacy networks, set compensation formulas for pharmacy payments, and determine patient co-payments – and often do so behind the scenes, hidden from public view.

    During his 2024-25 budget address, Gov. Shapiro called for legislation to reform the operations of PBMs to help Pennsylvanians impacted by the rising costs of prescription drugs and bring price transparency into the pharmaceutical supply chain. The bipartisan HB 1993 grants the Pennsylvania Insurance Department (PID) the authority to regulate PBM practices and contains several important protections that will benefit commercially insured Pennsylvanians.

    “Governor Shapiro has been unwavering in his push for bipartisan legislation that had the tools to reform the operations of PBMs,” said Commissioner Humphreys. “With the signing of this bill, our department now has the necessary resources to protect commercially insured Pennsylvania consumers and increase transparency and accountability when it comes to PBMs. Most importantly, this allows PID to gain a stronger understanding of the drivers of prescription costs, which will subsequently help us ensure consumers are paying a reasonable price for their medication, at a pharmacy nearby.”

    HB 1993 provides several tools to help Pennsylvanians save money including:

    • Prohibiting certain “patient steering” practices, such as requiring a policyholder to purchase drugs exclusively through a mail order pharmacy or at a pharmacy owned or controlled by the PBM.

    • Banning claw backs that lead to higher out-of-pocket expenses for consumers at the pharmacy counter.

    • PBMs artificially inflate co-pays so that they can collect profit. For instance, if a consumer copay is $20 and the drug’s actual cost is $5, PBMs and insurers “claw back” the $15 difference for profit.

    • Prohibiting PBMs from unilaterally altering the terms of a contract with a pharmacy or pharmacy services administrative organizations.

    Before this bill, PBMs had the ability to alter terms of a contract without input from pharmacies, which would make it difficult for some small pharmacies to do business. As a result of this bill, PBMs now must confer and get agreement from pharmacies before changing terms of a contract.

    Sen. Argall: Pennsylvania colleges must fight campus antisemitism

    After hearing disturbing accounts of antisemitism on college campuses across Pennsylvania, state Sen. Dave Argall, R-Pottsville, this week called on college administrators to take stronger actions against the perpetrators of this hatred during a public hearing of the Senate Education Committee.

    “It’s deeply troubling to hear that blatant antisemitism was allowed to fester on campuses here in Pennsylvania,” said Argall. “Let me be absolutely clear: action must be taken to prevent this from happening here again.”

    Argall, the chair of the Senate Education Committee, called this public hearing to hear directly from students about their ordeals since the October 7 massacre, where Hamas terrorists killed more than 1,000 Israelis, most of whom were civilians. Since that day, many organizations that track instances of antisemitism have documented a dramatic rise in incidents.

    The Anti-Defamation League testified that the number of antisemitic instances on college campuses jumped from 9 in 2022 to 54 in 2023, an increase of 500%. They also shared that since the terror attacks, the share of students who feel comfortable with others knowing they are Jewish declined from 63.7% to 38.6%.

    Testifiers noted the importance of the Stand with Israel Act, legislation which would prevent Pennsylvania colleges and universities that boycott or divest from Israel from receiving any state tax dollars. Earlier this year, Argall voted in favor of this bill when it was approved by a strongly bipartisan vote of 41-7 in the state Senate. It now awaits consideration by the House State Government Committee.

    State funding to develop mine-scarred land into business park in Hazle Twp.

    A highly competitive state grant of $2 million and a low interest loan of $3 million were awarded to CAN DO, Inc. and Mericle Commercial Real Estate Services this week to develop the Crossroads East Business Park on mine-scarred land in Hazle Township, according to Sen. Dave Argall, R-Pottsville, and Rep. Dane Watro, R-Hazleton.

    “Mericle Commercial Real Estate Services is a long-standing partner of our ongoing efforts to foster economic development across Greater Hazleton and we are proud to support the pivotal role they play in enhancing our community through projects like the Crossroads East Business Park,” said Joseph Lettiere, President & CEO of CAN DO, Inc. “Private development projects such as these directly assist in accomplishing our mission to improve the quality of life in the Greater Hazleton Area through the creation and retention of a full range of employment opportunities and exemplify Mericle’s unwavering, decades-long commitment to driving economic growth in our community.”

    “Effective public-private partnerships like this for shared infrastructure investment can help transform a local economy”, said Mericle President Rob Mericle. “Our team will construct a mix of industrial and flex buildings in CrossRoads that will help us attract a variety of manufacturing, life sciences, logistics, and business services companies that will create thousands of new jobs for the region and generate millions of dollars in new capital investment. We greatly appreciate the support we have received from Sen. Argall, Rep. Watro, Rep. Mike Cabell, and the Pennsylvania Department of Community and Economic Development to accelerate economic growth throughout the Greater Hazleton area.”

    The proposed business park will be located on State Route 424 along Interstate 81 between exits 141 and 143. Phase 1 of the project will develop 190 acres of mine-scarred land at the site into ten buildings, which are estimated to create 700 jobs.

    “Strong public-private partnerships have again brought new economic opportunities to the Greater Hazleton community and beyond,” said Argall. “I look forward to continuing this important work with CAN DO and the many other local leaders who have contributed to the economic resurgence of the region.”

    “This funding is the exciting next step in the development of the Crossroads East Business Park and the hundreds of jobs it’s expected to create,” said Watro. “I was pleased to join Sen. Argall in advocating for this financial support from the state to continue growing our regional economy.”

    This funding was awarded through the Business in Our Sites program, which helps ensure locations are “shovel-ready” for employers looking to set up shop in Pennsylvania. Funding was approved today during a public meeting of the Commonwealth Financing Authority, an independent agency that administers state programs and investments in Pennsylvania’s economic growth.

    Rep. Watro named to House Agent Orange Task Force

    Rep. Dane Watro, R-Hazleton, this week announced he has been appointed to serve on the Pennsylvania Task Force on Agent Orange and Other Toxins in the House of Representatives by Republican Leader Bryan Cutler (R-Lancaster).

    The task force was created earlier this year with the unanimous adoption of a bipartisan House resolution of which Watro was a co-sponsor.

    The task force will be comprised of several members of military organizations and members of the House and Senate who will study and form recommendations on how best to communicate with Pennsylvania veterans affected by Agent Orange to connect them with the benefits for which they are eligible and available treatment options.

    “I would like to thank Leader Cutler for this appointment to serve on a task force that is going to have a positive impact on the lives of veterans exposed to Agent Orange and other dangerous chemicals during their service to the nation in Vietnam,” said Watro. “This issue is a personal one for me, as I have an uncle who is one of those veterans. He is now blind and struggles with his daily activities. We need to do all we can to help him and his fellow veterans whose lives have been forever changed by Agent Orange.”

    From 1962-1971, the U.S. military used a blend of herbicides known as Agent Orange to remove foliage that provided cover to enemies during the Vietnam War. The herbicide was banned when evidence of the harmful and sometimes deadly results of exposure began to emerge.

    Those who were exposed to Agent Orange are at risk of developing cancers, neurological and psychological conditions, and other long-term effects to the skin and heart.

    Watro is a U.S. Army veteran and a member of the House Veterans Affairs and Emergency Preparedness Committee.

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