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June Legislative Update: Provider Status and Pulling Back the PBM Curtain

Antonio Ciaccia, Director of Government & Public Affairs and Michelle Fitzgibbon, Lobbyist

SB 265:  Provider Status for Pharmacists

On April 17, hearings officially commenced on SB 265, which would grant provider status for pharmacists in Ohio law. The legislation will address a majority of the parts of Ohio law that currently omit pharmacists from the laws that allow for billing and reimbursement for pharmacist services.

After months of working on refining language and educating lawmakers and stakeholders, we were excited to finally get the process started. Our first hearing began in the Ohio Senate Insurance & Financial Institutions Committee with SB 265’s sponsor, Senator Matt Dolan (R-Chagrin Falls) presenting testimony on why he introduced the bill.

“By providing pharmacists with provider status, we are recognizing the profession as part of the continuum of care and enabling a provider the means to interact with patients in areas where they are specifically trained,” said Senator Dolan. Senator Dolan did an excellent job making the case for why barriers to accessing pharmacist-provided care should be eliminated.

On May 15, OPA coordinated testimony for the bill’s second hearing, where physicians, pharmacists, nurses, and patients all came forward to discuss the importance of creating a financial pathway to add pharmacists to the healthcare team. The room was packed with pharmacists and students who were there to watch the hearing live. OPA Government & Public Affairs Director Antonio Ciaccia kicked off testimony and was followed by proponents who discussed the value of pharmacists and the barriers they’ve encountered due to a lack of provider status. The following OPA members delivered testimony:

They were also joined by physicians, Dr. Britni Lookabaugh (OhioHealth) and Dr. Richard Shell (Nationwide Children’s Hospital) in delivering their remarks in-person.

We would like to thank these individuals for making the trek to the Statehouse and speaking out in favor of SB 265, and we’d also like to thank OPA members Erin Thompson (University of Findlay College of Pharmacy), Julie Ehemann (Shelby County Commissioner), John Covello (Independent Pharmacy Cooperative), and Melody Hartzler (Western Medicine Inc.) for submitting written testimony for the committee. Additional thanks to Dr. Joseph Tobias (Nationwide Children’s Hospital), Dr. Edward Clack (Western Medicine Inc.), Dr. Renee Hebbeler-Clark (University of Cincinnati College of Medicine), Dr. Jacob Dean (Western Medicine Inc.), nurse Angela Corbett (Ohio State University Physicians Internal Medicine and Pediatrics), nurse Denise Gormley (University of Cincinnati College of Nursing), Lora Miller (Ohio Council of Retail Merchants), and patient Pamela Miller for submitting written testimony as well.

We anticipate future hearings on the bill soon, but for now, we thank all those who are working to support the bill.

Please contact your legislators, and ask for their support of SB 265.

The Columbus Dispatch Pulls Back the PBM Curtain

If you’ve been reading the OPA Pharmacy Newsline over the last two months, you know that someone turned the heat up on the PBM industry, and that “someone” is actually a slew of reporters at The Columbus Dispatch. After months of OPA banging the drum over shredded reimbursement rates from Medicaid managed care PBMs, while at the same time Medicaid spending on prescription drugs had increased; a major media institution finally asked the question, “What is going on here?”

In our first conversation with the Dispatch, they indicated that the problems that we discussed were possibly a big story that could be worth two to three articles. Two months later, they’ve run nearly 30 stories!

We would like to thank Darrel Rowland, Cathy Candisky, Marty Schladen, Lucas Sullivan, and the entire team at The Columbus Dispatch for their dedication to seeking out the full story on how PBMs operate and how they are taking advantage of their position in ways that put pharmacies out of business and increase drug spending by our state Medicaid program.

The prescription drug supply chain is opaque and confusing, and many journalists don’t have the time, energy, or resources to dig in to the degree necessary to learn what is going on. We applaud the Dispatch for investing in this issue in order to inform the public on what goes on behind the PBM curtain.

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