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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New Mexico Passes 340B Anti-Discrimination Bill, After Dropping 340B Contract Pharmacy Provisions

New Mexico state capitol building
New Mexico lawmakers passed a bill to stop pharmacy benefit managers from discriminating against 340B providers, but stripped it of language that would have outlawed drug manufacturers’ conditions on 340B sales when entities use contract pharmacies.

With just minutes to go in this year’s session, New Mexico lawmakers recently passed a bill to stop pharmacy benefit managers from discriminating against 340B providers including reimbursing them at a lower rate than other providers. Gov. Michelle Lujan Grisham

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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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West Virginia Hardens its 340B Anti-discrimination Law to Explicitly Bar 340B Claims Modifiers

Charleston Area Medical Center exterior sign and building
West Virginia has reinforced a 2019 law to bar PBMs or other payers from requiring hospitals such as CAMC and other health care providers to include claims modifiers when billing for 340B-purchased drugs.

West Virginia has reinforced its groundbreaking 2019 law forbidding what providers say is pharmacy benefit manager discrimination against 340B covered entities.

An amendment passed in March that took effect June 10 clarifies that PBMs or other third-party payers may not require a

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Arizona Lawmakers Pass and Send 340B Anti-discrimination Bill to Governor

Arizona Gov. Doug Ducey headshot
Arizona lawmakers have sent Gov. Doug Ducey (R) legislation prohibiting various forms of pharmacy benefit manager discrimination against 340B covered entities.

Arizona lawmakers passed legislation last week prohibiting various forms of pharmacy benefit manager discrimination against 340B covered entities.

Gov. Doug Ducey (R) has not signaled if he will sign SB 1176, veto it, or let it become law without his

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Colorado Lawmakers Pass 340B Anti-discrimination Bill

Colorado state capitol building
Colorado lawmakers voted to stop health insurers, pharmacy benefit managers (PBMs), and other third-party payers from discriminating against 340B covered entities and their contract pharmacies.

The Colorado General Assembly has voted to stop health insurers, pharmacy benefit managers (PBMs), and other third-party payers from discriminating against 340B covered entities and their contract pharmacies.

Gov. Jared Polis (D) is expected to sign the bill, HB22-1122. He

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