Health insurance plans hire PBM’s to administer their drug plans, to negotiate better prices on drugs from drug companies. But one of the ways they make money is by taking a cut of money they save. Two of the biggest revelations about PBM’s in recent years have been that they’ve taken drug company rebates meant for patients as their own compensation, and that they’ve kept information from patients that could help the patient save money.
Last year, Georgia Congressman Buddy Carter, R-Pooler, proposed a bill to end the practice where PBM's demanded in their contracts with pharmacies that pharmacists be forbidden to tell customers when they could save money by paying all cash rather than going through their insurance plan. President Trump signed the bill into law in October and now pharmacists shouldn't face that "gag rule."
In the Georgia Legislature HB 323 asks for another piece of transparency from PBM’s: It would make them report to the state Department of Insurance how much they’re getting in rebates from pharmaceutical manufacturers and how much of that they’re not passing on to patients.
However, it doesn’t require that information to be public.
Laura Colbert, executive director of the patient advocacy Georgians for a Healthy Future, called the bill “a good first step,” but said that the best thing would be if the bill required the information to become public rather than sitting confidential in state offices.
The bill also broadens the ability of health care providers to insist on giving medicine in person rather than by mail.
HB 323 has some heavy-hitter co-sponsors, including the chairwoman of the House Health and Human Services Committee, Rep. Sharon Cooper, R-Marietta; the chairman of the House Regulated Industries Committee, Rep. Alan Powell, R-Hartwell; and the vice chairman of the powerful Rules committee, Rep. Matt Hatchett, R-Dublin, who is also chairman of the House Majority Caucus.