Independent Rx lobby urges feds to adopt tough PBM operating rules

ALEXANDRIA, Va. Maintaining a combative stance against the managed-care industry, the independent pharmacy lobby is urging the federal government to adopt a get-tough policy regarding the pharmacy benefit management firms that administer drug benefits for federal employees.

The new push is coming from the National Community Pharmacists Association. In a letter Monday to the U.S. Office of Personnel Management, NCPA SVP government affairs John Coster asked the agency to impose strict transparency rules on PBMs that serve government employees through the Federal Employee Health Benefits Program prescription drug benefit.

In his letter, Coster commends recently proposed OPM standards that would require that PBM’s disclose “potential conflicts of interest” and pass through all manufacturer rebates and other discounts to their customers –– including the federal employee health plan. Those proposed new rules would also grant OPM’s Office of Inspector General access to all PBM records and contracts.

“NCPA has long championed the need for both federal and state oversight of pharmacy benefit managers due to the problems our members and their patients continue to face in dealing with these unregulated entities,” Coster wrote. “PBMs have been permitted to operate virtually unchecked since their inception, slowed only by the increasing amount of litigation alleging fraudulent and deceptive business practices filed against the PBMs each year.”

Coster also urged Bill Zielinski, OPM’s associate director for retirement and benefits, to assure that the agency maintain those strict operating standards for PBMs that will serve the health insurance exchanges created by the Patient Protection and Affordable Care Act reforming the U.S. healthcare system. OPM will administer many of those health exchanges, Coster pointed out in his letter.