Governor Haley Barbour would often say, "good policy makes good politics" as an encouragement to stay focused on the mission of economic growth (and as a warning against allowing the superficiality of politics to influence complex policy). Occasionally, an important issue crops up in the Legislature that serves as a good test for lawmakers with stark contrast of good policy vs local politics.
HB 1123 is one to watch. The bill in its current form, heading back to the House after passing the Senate, supposedly aims to help independently owned pharmacies at the expense of national pharmacy benefit managers (PBMs). The problem is, those PBMs are unharmed, and the expense of the government meddling in private contracts will fall on Mississippi employers who provide health insurance to their employees, like locally owned manufacturers, energy companies, construction companies and banks.
For example, amendments added in the Senate would alter agreed on contracts and increase contracted drug costs at all pharmacies if a single pharmacy can show a loss, regardless of what other pharmacies are paying. This increases drug costs and employer costs, and does not impact PBMs in the way it probably intends. Also, self-funded employer health insurance plans are not regulated at the state level but are not excluded from the legislation. If not excluded, costly and time-consuming legal action by these businesses to protect their plans and employees is expected.
Set the details of this issue aside, adding many millions of dollars of operating costs on some of Mississippi's best employers with no benefit in return is always terrible policy, no matter how many phone calls lawmakers get.
Whatever the fate of HB 1123, votes on this bill and whether it passes in its current form will be a good litmus test in who's for good policy. Most would probably agree finding a way to improve business conditions for locally-owned pharmacies is a worthy mission but not at the expense of other local employers. Solution? One good option would be returning the bill to its original form and avoiding piling unnecessary costs on employers.
This post was authored and sponsored by Mississippi Energy Institute Executive Director Patrick Sullivan.
28 comments:
It smells so much that a PBC such as CVS Caremark also has a corporate interest their own pharmacies. There are some instances of the reimbursements to local pharmacies are pennies. No one can stay in business with that return. There needs to be more transparency.
What a crock.
These people are for PBMs. PBMs are designed to kill local pharmacies, which are local businesses which support other local businesses. Support your local pharmacy, not the big drug/PBM industry.
Local pharmacies are vital. Please don't fall for slick pitches from lobbyist with 7 figure retainers.
If you're on Medicare and have a prescription drug plan, you pay for it monthly and the plan dictates where you shop (if you want the lower cost of drugs offered by the plan).
I have Silver Script as a drug plan and either they own CVS or vice versa. So, I'm sorta had by the balls.
I don’t know about this. But any entity or job description with the word “manager” in it gives the whiff of rotting fish to me.
When the PBM has more MBAs and attorneys than pharmacists on staff you know who is doing the bending over!
"This post was authored and sponsored by Mississippi Energy Institute Executive Director Patrick Sullivan. " Keep repeating the scare tactics that you've been fed. Being used as a proxy by the PBM's.
Many other states have passed meaningful PBM reform and it's been proven in these states that costs go down, not up. The Mississippi Board of Pharmacy recently released the results of an audit on Optum, a PBM, that proves Optum pays it's own pharmacies up to 22 times more than what they pay independents for the same medication. So I ask you, when PBM's force the insured to use the higher cost alternative (via steering), who is it that is really increasing the costs you pay?
One of the provisions of this bill that the Mississippi Energy Institute wants stripped out is an anti-steering provision. Basically Patrick Sullivan wants you to be forced to use whatever pharmacy your PBM decides and not whoever you want to use. If you want to use whatever pharmacy YOU choose, HB1123 is good for you. Don't want to be forced to use mail order? You won't have to. Don't want to be told you must go to CVS? You won't have to. Call your Representative and tell them you want them to concur on HB1123.
It’s like that scene in 8 Mile “pay attention meathead, you’re saying the same shit that he said.”
***points at MS Bankers Association***
Are yall bought and paid for by the same PBM?
PBMs have bought and paid for plenty of the folks deciding the fate of the bill.
If we are left with Walgreens and CVS to deal with for prescription drugs, God help us all!!
This is a garbage article. I have several clients who are locally owned pharmacists. The PBMs (distributers) and the Retailers (CVS) have consolidated and are driving locally owned pharmacies out of business by charging them much higher prices for the same drugs. Classic monopoly. I wonder what prices will do once the Mom and Pops are gone? If you wonder why your legislater votes against this check into how much money was donated to their campaign by these out of state organizations. Hint: It is the same folks buying their steaks at Ticos or wherever folks eat in Jackson these days. Kingfish, how much were you paid to publish this article? I'm not judging you... but would be curious to know.
This post was authored and sponsored by Mississippi Energy Institute Executive Director Patrick Sullivan. I agree that the big picture is more important than local politics. So where are the FACTS you have to support this claim? I don’t see any FACTS in your statement or anywhere else to support your claim. It looks more like a last minute frantic ditch effort from high dollar PBMs to BULLY certain groups in Mississippi. They both BULLY your companies/industries and then continue to make these employers and employees suffer even though they sign these contracts. Yesterday it’s bankers. The other day it was shipbuilding. Today it’s MS Energy. How come almost ALL other states have passed PBM reform EXCEPT Mississippi? I can cite numerous FACTS and POSITIVE RESULTS from many other states. Why are you even entertaining FALSE statements of the PBM bullies to push this state BACKWARDS? The MS Senate & House have worked TOGETHER. Local pharmacies have made some FAIR concessions. What am I missing here? It should be a no-brainer to CONCUR HB1123. The people have spoken. It’s in the best interest of those who were elected by the people to honor their wishes.
Then why are the JP Morgan employees suing because the PBMs significantly increased their drug prices and premiums.
Mr. Sullivan, Do your own homework!! Have you researched what other stat es have done and how costs are lowered when PBMs have some oversight?? Have you watched the documentary “Modern Medical Mafia “ ?? No, I didn’t think so! The federal government is getting involved and is investigating the unfair mafia-like business practices of PBMs where they make billions of dollars a year at the expense of independent pharmacies. When all of their illegal and unethical practices are exposed, YOU will be the one looking like the fool!!
8:26
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fetch
4:58 1
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BECKER'S
PAYER ISSUES
The lawsuit also notes that JPMorgan
previously launched initiatives such as
Haven Healthcare, which aimed to address
PBM practices and improve employer-
sponsored health plans across industries.
According to the suit, the bank allegedly
ignored reform recommendations before
Haven was shuttered in 2021.
The plaintifs argue that JPMorgan could
have saved millions of dollars by choosing
better pricing options or a more transparent
"pass-through" PBM model. Instead, the
plaintiffs claim that JPMorgan's failure to
explore alternatives led to excessive costs
for employees and their families through
higher drug costs and overall premiums
The lawsuit is seeking to recover any
overpaid costs and ensure future plan
compliance with ERISA.
Several large employers and insurers have
faced lawsuits in recent years from
employees over claims of mismanaging
health and pharmaceutical benefits and
violating their fiduciary duties, with notable
examples including Owens & Minor, Kraft
Heinz, Wells Fargo and Johnson &
Johnson. In January, a federal judge
partially dismissed the lawsuit against J&J.
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Just like any other business would tell you: None of your business.
I hope some smart lawyer files a class action lawsuit against the PBMs and the big corporations that support them!!!
PBMs forcing mail order at the same time the USPS can't deliver seemingly anything on time, or within a reasonable time window, is screwing over senior citizens.
So Kingfish, if as you say “any business would tell you “it’s none of their business””, so do you agree that contracts including controlled substances that are under the supervision of the DEA and MS Board of Pharmacy do not need to be transparent to the entities that supervise them? How can these entities (DEA & MS Board of Pharmacy) effectively accomplish their supervision roles without this adequate information, yet are subject to scrutiny if the supervision is lacking? This matter is concerning to me.
Since you are reading comprehension challenged, I will spell it out for you. You asked what the paid post paid. I said it was none of your business. What I really meant was none of your damn business. That had nothing to do with the contracts you mentioned and you know it.
The local pharmacies are at a tremendous disadvantage with signing these PBM contracts. Its basically a take it or leave it situation. If the local pharmacies discuss contract details and whether to accept it or not, that's considered collusion, which can be prosecuted. Its not a level playing field for locals.
Big Business (PBM) outside of Mississippi are paying politicians and now bankers to run Mississippi small businesses out business. Call your pharmacist asked them. We support our pharmacists not outsiders and PBMs
In MS, you can be sure that what ever industry a law is meant to restrain was actually written by that industry for the benefit of that industry. In this case, the PBMs paid for the language in the bill, and they are paying for the legislators that they need to get it passed.
PBM's having been killing small off small pharmacies by the hundreds yearly. They pay so little (many times below the pharmacy's actual cost) and then have policies that you must meet at a certain percentage on their guidelines on all their claims, or they will use that as an excuse to claw back more money from the pharmacy each year. They pay the pharmacy one price, then charge the insurance/entity another higher price (sometimes extremely higher), and pocket that money in addition to the management fee. Trust me, the only PEOPLE that PBM's care about are PBM's. And this incestual like relationship that exists with CVS and CVS/Caremark is the worst. Talk about spread pricing and patients being steered to certain pharmacies only. The only problem with HB 1123 is that it does not go far enough, but there is finally beginning to be some movement on the national level against PBM's. Too little too late for many local independent pharmacies, however.
Kingfish, as I do not consider myself reading comprehension challenged as you most rudely deemed me to be, I was merely giving you the opportunity to clarify your answer. I was unclear in your response and didn’t know if you and/or other readers were aware that currently the MS Board of Pharmacy does NOT have access to the contracts between the PBMs & businesses. These contracts still fall under the supervision of the MS Board of Pharmacy.
Article is a load of horseshit.
When special interest groups start paying to post things here, there, or anywhere else, that outline the whole argument, pro and con, the upside and the downside, I'll take them seriously. Until then, it's just fucking advertisement selling things to people who neither understand them or can actually afford them.
How so? Be specific.
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