Illinois pharmacies seek transparency on state managed-care contracts

Independent Illinois pharmacies are hoping legislation in the General Assembly's fall veto session gets passed that will require pharmacy benefit managers to disclose the details of their deals with HealthChoice Illinois, the state's Medicaid managed-care program, according to the Herald & Review.

Pharmacies say the bill would reveal information about suspected profit-padding by PBMs and reductions in reimbursement rates pharmacies receive from Medicaid patients. House Bill 3479 was passed by the House during the last legislative session but was not voted on in the Senate.

"We had a tough lift with getting the bill as far as we did," Garth Reynolds, executive director of the Illinois Pharmacists Association, told the Herald & Review. "We will continue to work on this over the summer. It's the political process. This is going to be a long fight."

A new, amended version of the bill would protect against gag clauses and allow pharmacists to tell patients about cheaper medication alternatives, and also allow independent pharmacies to withdraw from managed-care networks while remaining in private insurance networks. However, this version of the bill removes a reimbursement rate increase proposed in a previous version of the bill.

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