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10/26/2021 06:42 PM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20210&cosponId=34849
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House of Representatives
Session of 2021 - 2022 Regular Session

MEMORANDUM

Posted: February 26, 2021 09:12 AM
From: Representative Carrie Lewis DelRosso
To: All House members
Subject: Safety Net Provider Protection
 
In the near future, I intend to introduce legislation that will continue the hard of work the General Assembly to curb the predatory practices of Pharmacy Benefit Managers (PBMs) in the Commonwealth.  My legislation will be targeted at the practices being used by PBMs to interfere with the funding stream health centers and 340(b) plans use to fund the care they provide to low-income, uninsured residents.

In 1992, the federal government established the 340B Drug Pricing Program to provide certain safety net providers with an additional funding mechanism.  Drug manufacturers that participate in the Medicaid program also provide outpatient drugs to health care clinics, and other covered entities, at significantly reduced prices.  The intent of the program is to allow these entities to stretch scarce federal resources as far as possible, reaching more eligible patients and providing more comprehensive services.  By purchasing medications at a lower cost, these entities can pass the savings along to their patients through reduced drug prices, and/or use the additional savings to support their mission to expand access and improve health outcomes of their patients.

As Pennsylvania continues to fight predatory practices by certain PBMs, another issue has emerged: PBMs in Pennsylvania, and other states across the country, are targeting 340B providers with contracts that absorb all or part of the 340B savings, generally by reducing reimbursement. As a result, the PBM diverts the 340B savings - intended to care for underserved patients - to their own for-profit coffers. Unfortunately, due to a lack of options, covered entities are left in “take-it-or-leave-it” contract scenarios. If a covered entity signs a discriminatory contract, they give away their savings and support for services. However, if the covered entity does not sign, they both lose the savings and support, and can only offer few, if any, locations for their patients to access needed medications. Both options present significant access to care issues, regardless of the patient’s insurance status, in some of our most medically underserved communities.
 
My legislation will prohibit imposing fees or reducing reimbursement to Pennsylvania 340B providers - just because they are a 340B provider. The bills protect the intent of the 340B Program by ensuring the savings are directed to our most vulnerable and not PBMs. 

Please join me in sponsoring this important legislation to protect these valuable clinics in the Commonwealth and allow them to continue their mission.

 



Introduced as HB1319