The content of these pages is developed and maintained by, and is the sole responsibility of, the individual senator's office and may not reflect the views of the Nebraska Legislature. Questions and comments about the content should be directed to the senator's office at email@example.com
Since being elected as your State Senator, I have heard from many of our locally owned pharmacies and their issues with Pharmacy Benefit Managers, also known as PBM’s. As a retired insurance agent, I have introduced and successfully guided legislation across the finish line to help address the issues raised, whether it has to deal with price transparency, claw back provisions in contracts, or gag clauses prohibiting pharmacies from telling the consumer how much the drug actually costs.
While we have made some progress, there is still much work to be done because it is such a complex issue for all stakeholders. Knowing this is an ongoing issue, this year, I introduced LB 375, a bill that would adopt the Pharmacy Benefit Manager Regulation and Transparency Act. Before its introduction, I assured all stakeholders I would be willing to meet with them and listen to their concerns about the legislation. With this in mind, on Friday, February 12, I, along with Chairman of the Banking, Commerce and Insurance Committee Matt Williams, and Senator Adam Morfeld, hosted a roundtable discussion with pharmacists from across the state, representatives from the insurance industry, and representatives from the PBM industry.
We heard from all attendees about issues ranging from auditing requirements, maximum allowable costs, spread pricing, specialty pharmacies and drugs, drug coupons and rebates, and what is known as 340B programs, which is a topic I’d like to explain further. As a former insurance agent, I had not heard of this program before recently because it is an agreement between hospitals and other health care facilities and the pharmaceutical industry, but I believe it is something that deserves a lot more recognition.
The 340B program requires any pharmaceutical manufacturer that participates in Medicaid to sell outpatient drugs at a discounted price to healthcare organizations that care for uninsured or low-income patients, such as community health centers, children’s hospitals, critical access hospitals, and public and nonprofit disproportionate share hospitals that serve low-income and indigent populations.
These savings to the hospitals through the 340B program are then reallocated to provide healthcare-related services that may not otherwise be available. These savings allow hospitals to provide uncompensated care, additional patient care services such as chemotherapy in our more rural areas of the state, and provides them the ability to provide discounted and/or free drugs to patients in need. According to data I was provided, there are 64 hospitals from across the state that are not just eligible, but participate in this program.
I realize there is still much more work to be done on LB 375. While we did not come to an agreement today on how the bill should look moving forward, I believe we moved the needle. Pharmacists, pharmacy benefit managers, and the insurance industry all want to do what is best for their consumers while keeping costs of drugs low to allow for greater access. I believe with greater dialogue between all the stakeholders, and their commitment to this issue, it will be just a matter of time before we come to an agreement on how to move forward on this important topic.
As always, if we can be of assistance to you in any way, please do not hesitate to contact my office. My door is open and I have made it a goal to be accessible to the constituents of our district. Please stop by any time. My e-mail address is firstname.lastname@example.org, and the office phone number is 402-471-2756. Tyler and Katie are always available to assist you with your needs. If I am not immediately available, please do not hesitate to work with them to address any issues that you may need assistance. Please continue to follow me on Facebook at Kolterman for Legislature and on Twitter at @KoltermanforLegislature.