Empower Wisconsin | Feb. 13, 2020
By M.D. Kittle
MADISON — It’s rare that a bill gains the support of two-thirds of the Legislature. Those are the kind of numbers reserved for fairly innocuous resolutions.
A compromise measure expected to bring transparency to Pharmacy Benefit Managers (PBMs) as of this week had 98 co-signers. Only Act 19, legislation requiring local governments to cover health insurance premiums for survivors of law enforcement officers killed in the line of duty, appeared to have more co-signers this session, with 101.
While PBMs and their allies aren’t keen on Assembly Bill 114, the legislation does have the backing of a wide swath of Democrats, Republicans, and myriad members of the health care community.
After an emotional hearing last week featuring scores of horror stories about the powerful prescription drug middlemen, the Assembly Committee on Health’s executive committee this morning will vote on the bill. Its supporters expect it will be on the Assembly floor for debate before a shortened floor period wraps up next week.
It’s a watered down version to be sure from AB 114’s original provisions — in response to pressure from health plan and PBM lobbies. Still, the bill requires the benefits managers to be licensed with the state Office of the Commissioner of Insurance and demands clearer consumer language on drug formularies (approved medication lists). It implements “equitable” standards for PBM assessments and fees on pharmacies. And the bill codifies a federal law recently signed by President Trump that ends PBM “gag orders” on pharmacies, nondisclosure agreements that have driven up costs for consumers.
State Rep. Joe Sanfelippo (R-New Berlin), chairman of the Health committee, told Empower Wisconsin last week he thinks the health plan and PBM lobby see more oversight as inevitable. Some 40 states have some kind of transparency law in place, and President Trump touched upon PBM regulation in his State of the Union address.
“I think they recognize the party is over,” Sanfelippo said. “It’s an industry that operates largely under the radar. When you don’t know what’s going on and someone fights to keep you from knowing what’s going on, it raises suspicion.”