HARRISBURG – Sen. Wayne Langerholc, Jr. (R-35), Sen. Judy Ward (R-30), and Sen. Pat Stefano (R-32) today announced their intent to introduce legislation to substantially reform pharmacy benefit managers (PBMs) to better serve Pennsylvania residents.
PBMs are third-party companies that act as intermediaries in the prescription drug supply chain, managing drug benefits on behalf of health insurers, employers, government programs and others.
Act 77 of 2024 started the process of reigning in PBMs that were harming local pharmacies and jeopardizing the health and safety of commonwealth residents. While those reforms were an important step forward, additional action is needed to protect access to essential medical care.
The proposed legislation would grant the Office of Attorney General authority to review all contractual renewals and terminations between pharmacies and PBMs to assess their impact on local communities. It would also provide the Attorney General with statutory authority to pursue legal remedies against PBMs on behalf of the commonwealth and its residents, a power the office currently does not have.
Additionally, the legislation would require PBMs to appear in Pennsylvania courts for any cause of action arising from conduct within the commonwealth. This provision would prevent PBMs from forcing Pennsylvania residents to travel across the country to defend their access to essential medical care.
To improve government efficiency, the bill would require the state Board of Pharmacy to automatically notify PBMs of any disciplinary action taken against a pharmacy by the board or the U.S. Drug Enforcement Administration (DEA). It would also prohibit PBMs from holding a pharmacy license in Pennsylvania.
Finally, the legislation would expand contractual limitations established under Act 77 of 2024 by ensuring that terminations cannot occur solely based on the successful completion of corrective action plans, along with other measures designed to protect fair business practices and patient access to care.
“Over the past several months, I have worked collaboratively to address the current disruption in access to care in our region,” said Langerholc. “While productive conversations have taken place, it is now clear that further legislative action is necessary. The residents of the commonwealth should not have their essential prescriptions held hostage due to a contractual dispute.”
“Pharmacies are an important part of the medical team by providing patient access to life saving medications,” said Ward. “By allowing the Office of Attorney General to provide oversight to pharmacy benefit managers, we can ensure there is transparency and accountability to pharmacies across the commonwealth. Many pharmacies, especially community pharmacies, have closed their doors because of unfair PBM practices which has left many individuals and communities without a local pharmacy. These patients are left without adequate access and now must drive great distances to have a prescription filled.”
“Across our rural communities, we have consistently heard from constituents and businesses about the serious challenges that pharmacies are facing,” Stefano said. “My focus continues to be on protecting access to care and supporting our community-based pharmacies, which are vital to our area’s health and well-being.”
The legislation will be introduced in the near future.
CONTACT: Gwenn Dando (Langerholc)
Nathan Akers (J. Ward)
Amanda Cuteri (Stefano)