Bipartisan legislation proposed by U.S. Rep. Buddy Carter (R-GA) aims to bring pharmacy benefit managers (PBMs) into alignment with Medicare plans so that America’s senior citizens can shop at their local pharmacy of choice.
Rep. Carter on Sept. 12 sponsored the Neighborhood Options for Patients Buying Medicines Act, also known as the NO PBMs Act, H.R. 5400, alongside three original cosponsors, including lead original cosponsor U.S. Rep. Debbie Dingell (D-MI).
If enacted, H.R. 5400 would amend the Social Security Act to assure pharmacy access and choice for Medicare beneficiaries, according to the text of the measure.
“Seniors should be able to fill their prescriptions at the pharmacy that works best for them, not the PBM. Especially in rural areas, including Georgia’s First Congressional District, access to your local pharmacy is critical,” Rep. Carter said. “I’m proud to lead this bipartisan bill, which will allow independent pharmacies to compete on a more level playing field and bring accountability to PBMs.”
Specifically, H.R. 5400 would explicitly ensure that PBMs are required to comply with a standard under Medicare Part D that requires plan sponsors to have standard terms and conditions that are “reasonable and relevant,” and allow any pharmacy willing to accept the terms and conditions to participate in the sponsor’s network, according to a bill summary provided by Rep. Carter’s staff.
“All Americans, but especially seniors, should be able to conveniently access their necessary prescriptions. However, we too often hear about exploitative PBM practices complicating access to the pharmacies seniors depend on,” said Rep. Dingell. “Independent pharmacies are often an invaluable resource in underserved communities, and this legislation will ensure they can compete.”
H.R. 5400 is companion legislation to the same-named S. 2436 introduced on July 20 by U.S. Sens. Joe Manchin (D-WV) and Marsha Blackburn (R-TN) in their chamber.
The National Community Pharmacists Association, the American Pharmacists Association, the National Association of Specialty Pharmacy, American Pharmacy Cooperative Inc., and American Pharmacies endorsed the bill.