Laura Colbert, executive director of Georgians for a Healthy Future, agreed the issues of drug prices and transparency, coupled with the role PBMs play in the equation, will come up…
Action on surprise billing legislation
SB 8 received unanimous approval by the Senate on Friday, which means the bill will proceed to the House of Representatives to be considered. We expect to see some changes to the legislation as it moves through the House but anticipate that consumer protections and transparency requirements will remain intact. HB 71 will be voted on by the House of Representatives tomorrow.
Make a call to support surprise billing legislation:
- Call your Representative today to let them know that you support HB 71 because it protects consumers from surprise out of network medical bills.
- Call and thank your Senator for their support of SB 8.
Planning for new federally qualified health centers
Rep. Geoff Duncan has introduced legislation that makes some changes to the State Health Benefit Plan (SHBP) which covers teachers and other state employees and attempts to address barriers to accessing health care for rural and under-served Georgians. The bill would move the SHBP from the Department of Community Health to the Department of Administrative Services, and would require that in future plan years the SHBP include incentives for beneficiaries to utilize federally qualified health centers (FQHCs) for their primary care needs. The bill addresses health care access by establishing a task force that is charged with identifying 100 potential sites for new FQHCs across the state, and advising the Department of Community Health about how opioid addiction can be addressed through FQHCs and how to encourage the use of FQHCs by veterans for their primary care needs. There is no funding attached to this bill for the purposes of establishing the new health care centers. HB 300 has been referred to the House Health & Human Services Committee.
Opioid antagonist bill up for a vote
SB 121 codifies Governor Deal’s executive order to allow consumers to access opioid antagonist drugs (e.g. Naloxone) over-the-counter without a prescription. The legislation also requires that every pharmacy keep a record of every opioid antagonist dispensed as a result of the standing order and maintain the record for two years. Unlike SB 81, a bill with similar language, this bill would not require that pharmacists submit this information to the Prescription Drug Monitoring Program. The bill passed out of the Senate Health & Human Services Committee last week and is expected to receive a full Senate vote today.
“The Pharmacy Patient Fair Practices Act” approved by both House & Senate committees
HB 276 and SB 103 both seek to regulate pharmacy benefit managers, which are third party companies that manage the prescription drug programs of many insurance plans. Both bills would prohibit PBMs from requiring consumers use mail order pharmacies, charging consumers more if they choose not to use a mail order pharmacy, and disallowing consumers from using the pharmacy of their choice. The legislation would also prohibit PBMs from restricting pharmacies from offering home delivery to consumers with limited mobility. Additionally, PBMs would not be allowed to charge consumers more for prescriptions than pharmacies are reimbursed, steer patients to pharmacies owned by the PBM, or restrict pharmacists from advising patients about less costly prescription drugs. HB 276 and SB 103 were approved by the House and Senate Insurance Committees respectively and now rest in the Rules Committees.