PBM’s To Be Restricted Under New Law January 1st
One of the new laws that will take effect on Saturday…the first day of 2022 concerns your prescription drugs. Over the last few years, three pharmacy benefit managers…— controlled 80% of America’s prescription drug sales. They are the companies that negotiate prescription drug benefits with drug manufacturers. Those companies then set a reimbursement rate for pharmacies. A new law passed this year that goes into effect on January 1st will prohibit those pharmacy benefit managers from manipulating the reimbursement rate for certain pharmacies. That means PBMs in Tennessee can no longer reimburse some pharmacies at a rate lower than others…this is to prevent the PBM’s like Express Scripts, CVS Health/Caremark, and OptumRX from steering patients toward their-favored pharmacies. The law forbids the PBM’s to interfere with patients over which pharmacies they will choose.