Get PBMs to Squeeze 340B Drugs Harder, “Playbook” Advises Employers

A new "playbook" for business-sponsored health plans advises them to press PBMs to do more to ensure that health care purchasers get the benefits of 340B drug discounts.

A new “playbook” for employers on getting the upper hand with pharmacy benefit managers says PBM handling of 340B drugs is a top 10 concern for business-sponsored health plans.

Released yesterday by the Washington, D.C., based National Alliance of Healthcare

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Iowa Set to Enact Nation’s 25th 340B Nondiscrimination Law

Iowa state capitol
The Iowa Senate last week passed a 340B nondiscrimination bill 49-1, sending it to Gov. Kim Reynolds. The House passed it earlier 98-0.

The Iowa Senate last week passed a House-approved bill banning pharmacy benefit manager and payor discrimination against 340B covered entities and their contract pharmacies, including reimbursing the entities at a lower rate than non-340B providers.

The Senate voted 49-1 on

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New Mexico Governor Signs Bill Protecting 340B Providers from PBM and Payer Discrimination

New Mexico state flag
New Mexico Gov. Michelle Lujan Grisham (D) has signed a law to prevent PBMs and insurers from discriminating against 340B providers.

New Mexico Gov. Michelle Lujan Grisham (D) signed a law April 7 to prevent pharmacy benefit managers and insurers from discriminating against 340B providers.  The bill includes language that prohibits payers from reimbursing 340B covered entities at a lower rate

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Two GOP Senators Raise Concerns About PBM’s Infringement on 340B Savings in Recent Hearing

Jonathan Levitt pictured at Senate hearing
The 340B program "is completely frustrated" by pharmacy benefit managers, health care attorney Jonathan Levitt said during a during a Senate Finance Committee hearing on PBMs.

Two Republican U.S. senators expressed concerns about pharmacy benefit manager encroachment on 340B covered entity savings during a Senate Finance Committee hearing on PBMs last week.

“I often hear concerns from South Dakota hospitals and health centers when it comes

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U.S. House Oversight Committee Launches PBM Investigation

House Committee on Oversight and Accountability
A U.S. House committee is investigating “anticompetitive tactics” by Express Scripts, CVS Caremark, and OptumRx.

The U.S. House Committee on Oversight and Accountability last week launched an investigation into how “anticompetitive tactics” by the three largest pharmacy benefit managers—Express Scripts, CVS Caremark, and OptumRx—are driving up healthcare costs and hurting patient care within federal health

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Oregon Bill Targets PBM Policies that Discriminate Against 340B Pharmacies

Oregon House Bill 2716 image
A bill in Oregon would prohibit discriminatory practices by PBMs and insurance plans against 340B pharmacies.

Oregon legislators have introduced a bill that would prohibit discriminatory practices by pharmacy benefit managers and insurance plans against 340B pharmacies, including reimbursing a 340B pharmacy less for prescription drugs compared with non-340B pharmacies. 

If passed later this year, House

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Court Upholds $23 Million Judgement Against CVS Caremark for Unfair Pharmacy Reimbursement

Arcade claw game
CVS Caremark must pay AIDS Healthcare Foundation $23 million for Part D drug reimbursement that the PBM clawed back from AHF unfairly, a court says.

A federal district court in Arizona has upheld a $23 million arbitration award to the AIDS Healthcare Foundation (AHF) against pharmacy benefits manager (PBM) CVS Caremark for unfair drug reimbursement.

In its November 2019 lawsuit, AHF alleged that CVS Caremark

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Vermont Passes Bill Enhancing 340B Anti-Discriminatory Protections but Measure Aimed at Drug Manufacturers Fails

Vermont State House building
Vermont recently extended its prohibition on discrimination by PBMs against 340B entities but did not require drug manufacturers to provide 340B-priced drugs to contract pharmacies.

The state of Vermont has passed a bill extending its prohibition on discrimination by pharmacy benefit managers (PBMs) against 340B covered entities, which was originally passed in June 2021 as part of the state’s 2022 budget. 

The bill was quietly

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Exclusive: 340B Entities Report Unannounced and Unexplained Claims Reversals Involving CVS and Blue Cross Blue Shield

Blue Cross Blue Shield wordmarks
Providers say claims have been reversed without notice or explanation for 340B-purchased drugs that CVS Specialty dispensed to BCBS FEP participants.

UPDATE Wednesday, June 22, 2022, 2:50 p.m. EDT—CVS Health issued this statement: “We do not comment on specific PBM client contract terms. Our clients are sophisticated purchasers, and we work closely with them to customize a benefit design meeting their

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