Vermont’s legislature has voted to bar pharmacy benefit managers (PBMs) from requiring claims modifiers on 340B-purchased drugs, except for claims paid directly or indirectly by Medicaid. | Tony Fischer https://www.flickr.com/photos/tonythemisfit/

Vermont Places 340B-Related Strictures on PBMs and Adds Protections to Contract Pharmacies

Vermont’s legislature has voted to bar pharmacy benefit managers (PBMs) from requiring claims modifiers on 340B-purchased drugs, except for claims paid directly or indirectly by Medicaid.

PBMs also would be unable to restrict 340B contract pharmacies’ access to pharmacy networks or to adjust their reimbursement rates. Lawmakers directed the state consumer protection department, in consultation with state Attorney General T.J. Donovan (D), to report by Jan. 15, 2022 on “national activity affecting participation” in the 340B program, including

  • changes in how drug manufacturers pay PBMs rebates on prescriptions filled with 340B-purchased drugs
  • how such changes potentially affect Vermonters
  • possible state responses to manufacturer and PBM actions related to participation in 340B.

Manufacturers Eli Lilly, AstraZeneca, Novartis, and Sanofi have disclosed that they have received subpoenas from Donovan related to their denials of 340B ceiling prices on drugs shipped to contract pharmacies.

The state’s new 340B-related measures were included in a state budget bill given final passage on May 21. Gov. Phil Scott (R) is expected to sign the bill.

Editor at Large | Website | + posts