SF0151 may be lifeline for local pharmacies

Making its way through the legislature, Senate File 151, sponsored by Wyoming District 05 Senator Lynn Hutchings, is an Act relating to the insurance code and regulating specified actions by pharmacy benefit managers.

While appearing on Sheridan Media’s Public Pulse program, Sheridan based pharmacist Dr. Matthew Meyer told listeners the need for the bill revolves around the policies of pharmacy benefits managers (PBM). 

The PBMs essentially decide if and how much insurance companies will work with locally owned pharmacies. PBMs work for the insurance companies who see a cheaper rate with large mail order companies and have enacted policies to exclude local pharmacies from insurance networks or reduce the amount of reimbursement rates paid to the locally owned pharmacies, undercutting local pharmacists to the point they are forced to close their doors. 

According to Meyer, the bill making its way through the legislative session, SF0151, will help level the playing field. The bill reduces what PBMs can dictate to Wyoming patients as well as regulate the contractual practices that are forcing Wyoming community pharmacies out of business. Among other regulatory policies, the bill will;

• Prohibit a PBM from billing an insurance company a larger payment than that paid to the pharmacy for any prescription service.
• Prevents a PBM from restricting a pharmacy from viewing access to their current PBM contracts.
• Requires audit appeals reporting to the Wyoming Department of Insurance and transparency to PBM drug acquisition pricing on any appealed medication.

Meyer told listeners that arguments against the bill cite increased cost. 

The bill has a long journey ahead before becoming law. At the time of this story, the bill had cleared the Appropriations Committee and awaits first reading on the Senate floor. 

Read the full bill, here.