The National Association of Chain Drug Stores (NACDS) is hailing New York State for taking action that will help protect New Yorkers’ choice of pharmacy and access to the medications right for them.
On November 20, in a critical move, the New York State Department of Financial Services adopted new market conduct regulations to govern Pharmacy Benefit Managers (PBMs) operating in that state.
Notably, the adopted regulations will require the following:
- “Allow Home Delivery. Prohibit PBMs from barring any in-network pharmacies from providing mail order or delivery services, which will increase patients’ access to home delivery from their community pharmacy;
- “List Pharmacy Directories. Increase transparency to consumers and employers by requiring PBMs to list formularies and pharmacy directories online, and prohibiting PBMs from punishing a consumer who relies on said information;
- “Address Consumer Inquiries. Require PBMs to post a telephone number and email address for consumers to direct their questions to, and PBMs must respond in a reasonable amount of time;
- “Prohibit Steering. Prohibit anti-competitive practices that steer consumers away from their community pharmacy to larger pharmacies affiliated with the PBM;
- “Allow Electronic Submissions. Reduce administrative burdens and costs on small pharmacies by allowing them to submit information to and receive information from PBMs electronically;
- “Apply Same Standards. Prevent the abuse of audits against small pharmacies who are not affiliated with a PBM by requiring PBMs to apply the same audit standards across all in-network pharmacies;” and
- Treat Pharmacies Fairly. Prohibit PBMs from unfairly seeking to retroactively deny reimbursement to the pharmacy, effectively preventing pharmacies from taking losses after a prescription has already been dispensed to a consumer and a claim adjudicated;
“We applaud Governor Kathy Hochul (D-NY) and the New York State Department of Financial Services for continuing to prioritize people over PBM profits,” said NACDS President and CEO Steven C. Anderson. “New York is yet another state standing up for communities in the face of the ‘pharmaceutical benefit manipulation’ that deprives people of their choice of pharmacies and that force pharmacies of all sizes to close their doors.
“Adoption of the new PBM market conduct regulations is a major victory for patients across New York — and a nation-leading model for other state governments working to rein in the harmful tactics of PBM middlemen. NACDS is here to stand up for the leaders who stand up for patients, pharmacies, employers, taxpayers, communities and the entire state by enacting, implementing, enforcing and defending PBM reform laws.”
NACDS’ all-levels and all-branches of government approach to PBM reform prioritizes the enactment, implementation, enforcement and oversight of reforms – in recognition of PBM middlemen’s predictable efforts to thwart reforms in any way possible.
NACDS urges the federal and state governments to perform their appropriate roles — and to help reduce Americans’ prescription drug costs, to protect Americans’ access to their trusted and convenient pharmacies and to medications prescribed by their doctors, and to end PBMs’ predatory practices that threaten pharmacies’ viability. Consistent with this approach, NACDS is urging the U.S. Congress to enact PBM reforms that have strong bipartisan support, and to do so before adjourning for the year.
More information is available at NACDS’ Access Agenda microsite.
