AAPA’s goal of improving access to care for all Michiganders through our independent pharmacies is one step closer to being codified into law. A special thank you to our champions in Lansing who have been hard at work on our behalf to get House Bill 4276 across the finish line. The bill passed through the Michigan House of Representatives by a vote of 105-4.
What Does The Passing of This Bill Mean?
Medicaid-managed care organizations (MCO) utilizing a pharmacy benefit manager (PBM) to reimburse pharmacies with seven or fewer retail outlets for drug products at the lesser of:
- the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee;
- the Wholesale Acquisition Cost (WAC) plus a professional dispensing;
- or the pharmacy’s usual and customary fee.
The bill also mandates Medicaid-managed care organizations move to a transparent pass-through pricing model, and that the PBM disclose its administrative fees as a percentage of the professional dispensing costs to the Michigan Department of Health and Human Services.
Additionally, the bill prohibits a PBM from implementing new administration fees as well as the ability of an MCO to terminate a pharmacy from its network on the basis of having to reimburse a pharmacy at the designated rate.
This bill is expected to lower overall pharmacy reimbursement costs and save the state between $5-12 million.
Follow along with us as we continue to support Michigan Independent Pharmacies!
