Missouri state senators in recent weeks have introduced three bills with provisions to bar pharmacy benefit managers (PBMs) from what 340B providers describe as underpayments and other discriminatory practices.
On Jan. 3, Missouri state Sens. Curtis Trent (R) and Doug Beck (D) each introduced identical bills, SB 978 and SB 1035, respectively, that would prohibit alleged underpayments from PBMs to federally qualified health centers (FQHCs) for 340B drugs. They also would bar PBMs from placing any restrictions on FQHCs or their contract pharmacies on the basis of their 340B status.
Broader Bill Would Protect All 340B Providers
Also on Jan. 3, Missouri state Sen. Mike Moon (R) introduced a bill, SB 1213, that would prohibit PBMs from underpaying any 340B covered entity or placing any added restrictions on their pharmacy access on the basis of their 340B status. SB 1213 also included broader PBM transparency measures that were not specific to 340B.
All three bills were referred Jan. 25 to the Insurance and Banking Committee. Trent is vice-chair of that committee, while Beck and Moon do not sit on the committee.
Follows Introduction of Contract Pharmacy Protection Bill
The three PBM 340B protection bills came after Missouri state Sen. Justin Brown (R) introduced a bill, SB 751, that would both prohibit alleged PBM 340B underpayments and bar drug manufacturer restrictions on 340B contract pharmacy use. Brown pre-filed SB 751 on Dec. 1, 2023, for introduction on Jan. 3, and it was referred to the Insurance and Banking Committee on Jan. 8. Brown does not sit on that committee.
Jane Drummond, general counsel and senior vice president of governmental relations for the Missouri Hospital Association, previously told 340B Report her organization had encountered obstacles when lobbying for 340B contract pharmacy and PBM differentiated payment protection provisions during the 2023 legislative session and was hoping efforts to educate lawmakers on the 340B program would lead to more success in 2024. Drummond could not be reached for additional comment on the new PBM underpayment bills.
None of the sponsors of the four bills could be reached for comment.
State 340B Activity
Twenty-seven other states already have laws in place that prohibit PBMs from reducing payments or restricting pharmacy access to providers on the basis of their 340B status. California was the most recent state to enact such a law on Oct. 7.
Meanwhile, with SB 751, Missouri is one of 13 states considering 340B contract pharmacy bills in the 2024 legislative session. Massachusetts is the only state to have a 340B contract pharmacy bill pass a legislative chamber during the current legislative session.
Amid this growing legislative activity, 340B Report has created a national tracking tool with our latest reporting on state laws that restrict PBM actions with respect to 340B covered entities as well as a tracking tool covering 340B state contract pharmacy legislation.