2020 Legislative Update: Week 6
Week 6 of Georgia’s legislative session (days 14-17) proved to be a busy one for pharmacy with several exciting pieces of pro-patient and pro-pharmacy legislation being introduced with an exciting array of bill sponsors and cosponsors.
HB 918: Strengthening existing PBM laws
Introduced by Rep. Sharon Cooper, this strengthens Georgia’s Pharmacy Audit Bill of Rights and strengthen the Pharmacy Anti-Steering Act passed into law last year via HB 233. Specifically, this bill looks to:
- Remove language in the law being relied upon by DCH to allow steering in the state health benefit plan;
- Update the audit bill of rights to increase Commissioner of Insurance authority and limit PBM recoupments from pharmacies to situations when there has been fraud; a mis-fill; or an overpayment; and
- Strengthen Georgia’s anti-steering law by prohibiting PBMs from steering via monetary penalties including withholding coverage; prohibiting PBM to PBM pharmacy referral arrangements; and apply steering protections to patients who receive limited distribution drugs and to patients in Medicaid managed care.
This is a critical piece of legislation for pharmacy patients which GPhA will advocate hard for.
HB 946: Mandating PBM Pricing reports
Rep. Knight’s HB 946 is a companion bill to SB 313 and it HB 946 looks to bring true transparency to prescription drug pricing in Georgia by
- mandating PBMs report deviations in connection with public pricing benchmarks,
- prohibiting spread pricing and retroactive recoupments, and
- requiring rebates to be passed back to payors.
It also seeks to protect patients by prohibiting practices including withholding coverage for lower cost generic drugs; failing to count copay assistance towards deductibles; and removing a drug from a formulary for the purpose of pushing patients to a different plan.
Finally, this bill looks to protect patient choice by strengthening anti-steering law, and imposing a first in the nation surcharge on PBMs and their insurer clients when they engage in the practice of patient steering to affiliated pharmacies.
HB 947: Studying a Prescription drug carve-out
Introduced by Rep. Knight, HB 947 sets forth some of the many problems in prescription drug administration in Georgia’s Medicaid managed care program including poor outcomes, self dealing, and high administrative costs. This bill looks to tackle these problems by tasking an actuarial study of savings to the state by carving prescription drugs out of Medicaid managed care and having those benefits administered in Georgia’s Medicaid fee for service program. If the study reflects savings of $20 million or more DCH will proceed with a carve out to implemented by July of 2021. If the savings are between $10 million and $20 million DCH is authorized to proceed.
Advocate!
All three of these bills are critical to patients and pharmacies in Georgia and it is important your legislators hear from you on how important each of these bill are. These bills have been assigned to the House Special Committee on Access to Quality Healthcare. Please reach out to the committee members below, let them know you support the legislation, and thank them for their support and work on behalf of Georgia’s patients.
Newton, Mark – Chairman
Cooper, Sharon – Vice Chairman
Bentley, Patty
Corbett, John
Frye, Spencer
Hatchett, Matt
Houston, Penny
Jones, Todd
Knight, David
Nix, Randy
Parrish, Butch
Pirkle, Clay
Prince, Brian
Smith, Richard H.
Smyre, Calvin
SB 313: PBM Regulation
We are hopeful this PBM reform bill will be heard in full committee this week. Please reach out to committee members (below) and ask for their favorable support — thank them for their time and consideration. Between its initial hearing and subcommittee hearing, approximately five hours of committee time has been spent on this legislation, and we are optimistic this bill will be in a position to move forward.
Jones, Burt – Chairman
Martin IV, P. K. – Vice Chairman
Harbin, Marty
Sims, Freddie Powell
Unterman, Renee
Watson, Ben
Burke, Dean
Harbison, Ed
Kirkpatrick, Kay
Lucas, David
Robertson, Randy
Walker III, Larry
Other Legislation introduced in week 6
SB 391: Emergency refills
Introduced by Sen. Kirkpatrick, this bill requires health insurers to provide coverage for early refills of a 30 day supply of certain prescription medications under certain emergency situations. While the Board of Pharmacy does an excellent job of acting quickly in emergency situations such as hurricanes, this bill contemplates removing hurdles on the insurer side. GPhA will continue to engage on this legislation.
HB 952: Prohibiting Controlled substance limitations
Introduced by Rep. Cooper, this bill prohibits “corporations that own and operate multiple pharmacies from implementing policies and procedures that restrict the quantity of controlled substances dispensed or restrict the prescriber while at the same time protecting the ability of dispensing pharmacists to utilize their professional judgment. GPhA will monitor.
HB 961: Gathering info on state prescription drug spending
Rep. Park’s bill looks to create a list of prescription drugs for which the state expends significant healthcare funds and authorizes the AG to require info. from drug manufacturers. GPHA will monitor and engage.
Previously introduced legislation
SB 272: Dextromethorphan ban
Sen. Robertson’s legislation which looks to prohibit the sale to and by minors of drug products containing dextromethorphan was favorably reported out of committee. GPhA has remained engaged on this legislation over the past several years and will continue to monitor and engage as necessary.
Senate Insurance and Labor Committee
Jones, Burt – Chairman
Martin IV, P. K. – Vice Chairman
Harbin, Marty – Secretary
Sims, Freddie Powell – Ex-Officio
Unterman, Renee – Ex-Officio
Watson, Ben – Ex-Officio
Burke, Dean (Also SB 313 Author)
Harbison, Ed
Kirkpatrick, Kay
Lucas, David
Robertson, Randy
Walker, III, Larry
