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Senate Committee Advances Medicaid Reform Bill

Wednesday, May 15, 2019   (0 Comments)
Posted by: Brian Sparks
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Medicaid payment reform for pharmacy is headed to the floor of the Texas Senate. HB 3388 was voted favorably from the Senate Health and Human Services Committee Wednesday evening, May 15. The bill, which easily passed the House May 3, requires PBMs in Medicaid managed care to establish a reimbursement floor for pharmacies, which guarantees pharmacies will be paid the Medicaid fee-for-service rate of the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee.

Texas Pharmacy Association CEO Debbie Garza testified Tuesday, May 14 before the Committee on behalf of all pharmacy groups in Texas in support of the bill. “All of pharmacy—big or small pharmacies, mid-size and in between, chains and independents, in rural and urban locations, YOUR pharmacists—appreciate the Legislature adding this new and refined tool to Medicaid Managed Care to establish a more robust and accountable payment methodology for prescription drugs in Texas Medicaid,” Garza said. “We appreciate the Texas Association of Health Plans working with pharmacy stakeholders to find a compromise that still provides an accurate and transparent system.”

Chairwoman Lois Kolkhorst, who sponsored the Senate companion bill, noted that this legislation has been worked on for many years in Texas. “I believe that this will lead to greater transparency and help us actually control costs,” she said. “My problem with PBMs has always been the 'black box'--an opaque system that we don't always get to look into.” Pharmacy thanks Senator Kolkhorst for her leadership and thoughtfulness on this important issue and thanks Rep. J.D. Sheffield for authoring the legislation.

 TPA CEO Debbie Garza testifies before the Senate Health and Human Services Committee in support of Medicaid payment reform.
TPA CEO Debbie Garza testifies before the Senate Health and Human Services Committee in support of Medicaid payment reform.


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