MPA has filed the critical bills below focusing on PBM reform in Missouri. As the session progresses, we will provide members with resources to raise awareness of our legislative priorities. Your advocacy will be essential in supporting these initiatives and driving meaningful change.

View all bills tracked for MPA here.

SB 45 (Fitzwater):  Senate Committee on Families, Seniors, and Health will hold this hearing Wednesday, January 22, at 8:30 AM in SCR 1, by Senator Jill Carter.
The bill;

• ensures plan sponsors know "rebate" amounts so they can collect those to offset rising drug prices.

• ensures transparency in PBM contracts, including preventing PBMs from blocking discussions between pharmacies and plan sponsors on health benefits.

• establishes a duty for PBMs to act in the best interest of health plan purchasers, bringing enforceable accountability to their business practices.

• safeguards pharmacies by preventing PBMs from reimbursing them at rates below the pharmacy’s cost to purchase and dispense drugs, while also ensuring PBMs cannot charge health plans or payers a higher price than what the PBM reimburses pharmacies.

• the bill protects patients by precluding health carriers and PBMs from double dipping patient’s pocket on copayments – ensuring payments made by enrollees or on their behalf are counted toward out-of-pocket maximums and cost-sharing requirements, and

• beefs up current law that states a patient’s copayment cannot exceed the cash price of the drug.

Finally, the bill addresses the latest price driver marketing practice by the PBM’s surrounding “specialty drugs”, ensuring that PBM’s ability to pay themselves a self-inflated cost for the drug is greatly diminished.  The FTC has focused a great deal on this issue, and has now determined this to be a greater cost driver to patients and plan sponsors than any other revenue stream for the PBM’s.  This latest report has really caught the attention of many employers.