The Senate passed a bill Wednesday that would increase the regulation and transparency of pharmacy benefit managers, which advocates argue will protect patients and independent pharmacists. 

The legislation, authored by Sen. Rita Parks, R-Corinth, beefs up a House of Representatives bill focusing on the transparency of pharmacy benefit managers by adding language to tighten appeal procedures, bar the companies from steering patients to affiliate pharmacies and prohibit spread pricing – the practice of paying insurers more for drugs than pharmacists in order to inflate pharmacy benefit managers’ profits. 

Parks said the bill, which passed 46-4, has the support of the House, which can now send it to the governor’s desk to sign or go to conference with the Senate to negotiate changes. 

“This is the furthest we’ve been in two years,” said Parks. “We’re bringing fairness to the patient and to independent pharmacists.” 

The bill’s passage came after a strong showing of support for reform from independent pharmacists, who have warned that if legislators do not pass a law this year to regulate pharmacy benefit managers, which serve as middlemen in the pharmaceutical industry, some pharmacies may be forced to close. They say that the companies’ low payments and unfair business practices have left them struggling to break even.

The Senate’s original bill died in the House, but the body revived most of its language by inserting it into a similar House bill, House Bill 1123, which was authored by House Speaker Jason White. 

The Senate made several concessions in the most recent version of the legislation, including forgoing a provision that would have required pharmacy benefit managers to reimburse prescription discount card claims within seven days. These claims are currently paid within 60 to 90 days, which pharmacists argue is a burdensome timeframe. 

The bill is a “good start” to real pharmacy benefit manager reform and transparency, said Robert Dozier, the executive director of the Mississippi Independent Pharmacy Association.

“The independent pharmacists are pleased with the current form of House Bill 1123,” he said. “They did not get everything they wanted, but they got what they needed.” 

The bill also gives the Mississippi Board of Pharmacy more tools to conduct audits and requires drug manufacturers, pharmacy benefit managers and health insurers to submit data to the Mississippi Board of Pharmacy, which will be available to the public. 

Sen. Jeremy England, R-Ocean Springs, said he is concerned the bill will lead to higher health insurance costs for employers, including the state itself, which provides health insurance to state employees. 

Pharmacy benefit managers negotiate rebates, or cost savings, for employers, and some critics of pharmacy benefit manager reform argue that regulating the companies’ business practices will lead to higher insurance costs for employers. 

England said that Mississippi employers stand to lose tens of millions of dollars and that regulation could deter new businesses from coming to the state. 

“This language that we are trying to put into state law here goes too far, in fact it goes to the point where it could end up costing jobs,” he said.

A vote requested by England to determine if a fiscal note is necessary for the bill failed. 

Parks said she disagreed that the bill would raise state health insurance costs and called England’s concerns a “scare tactic” meant to deter legislators from passing the bill.

England also proposed an amendment to the bill to remove self-funded insurance plans, or health plans in which employers assume the financial risk of covering employees’ health care costs themselves, from a section of the bill that prohibits pharmacy benefit managers from steering patients to specific pharmacies and interfering with their right to choose a particular pharmacy. 

Self-funded health plans often use pharmacy benefit managers to administer prescription drug benefits and process claims. 

Parks argued that excluding self-funded health plans from those guidelines would remove the fundamental protections the bill affords pharmacies and patients. 

England’s amendment failed. 

“Mississippi’s been a beacon in where we have stood with PBM,” Parks said. “We need to continue to be that beacon and not go backwards.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

March 12, 1998

Thirty-two years after Mississippi created a segregationist spy agency, the Mississippi State Sovereignty Commission, its long secret records were finally opened to the public. 

State lawmakers created the agency in 1956 in the wake of the Brown v. Board of Education ruling that ordered desegregation in public schools and gave the agency broad powers to fight federal “encroachment.” 

Under the direction of Gov. Ross Barnett, the commission promoted propaganda, sending white and Black speakers up North to talk about how wonderful segregation was. The commission also hired informants, infiltrated civil rights groups, smeared civil rights workers and got them fired from their jobs. 

The commission collected spy files on more than 10,000 people, including Elvis Presley. In addition, the commission sent more than $193,000 of taxpayers’ money to the white Citizens’ Council — a practice that drew criticism from Mississippi NAACP leader Medgar Evers. 

In spring 1964, the commission spied on two young white civil rights workers, Michael and Rita Schwerner, after they began to work in the movement in Meridian, Mississippi. The commission shared its spy report with the local police, which included the brother of Klansman Alton Wayne Roberts, who was involved in killing Michael Schwerner and two other civil rights workers, James Chaney and Andrew Goodman. 

In 1973, then Gov. Bill Waller vetoed the Mississippi Legislature’s appropriation to the commission, effectively shutting it down. In 1977, the Legislature abolished the agency and sealed the files for 50 years, but a lawsuit by the ACLU succeeded in opening those files.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Advocates, Medicaid recipients and their family members gathered outside the Capitol Tuesday to urge both state and federal lawmakers to “protect and expand Medicaid now.” 

Speakers, who held signs with slogans such as “pro-life span,” included representatives from the Mississippi Coalition for Citizens with Disabilities, members of Care4Mississippi, parents of children on Medicaid and one 9-year-old girl. 

Their presence was in response to recent federal action that threatens Medicaid funding nationwide. In February, the U.S. House of Representatives passed a budget resolution that calls for the committee that oversees Medicaid and Medicare to cut $880 billion over 10 years. 

“This budget may not explicitly mention Medicaid, but the math is clear,” said Pam Dollar, executive director of the disability coalition. “Lawmakers cannot meet their aggressive cuts without slashing Medicaid or Medicare. Even if they cut everything unrelated to health care, they would still be $600 billion short. In a state that prides itself on being pro-life, how can we stand by and allow this to happen?”

There are currently over 600,000 Mississippians enrolled in the program. Medicaid covers half of Mississippi’s children, three in four of its nursing home residents and three in eight people with disabilities, according to KFF. 

Susan Stearns traveled from Oxford to speak at the rally. She’s used to driving – and routinely makes a two-hour round-trip car ride every time her son Oscar is in need of a pediatric specialist. 

Oscar and his twin were born prematurely, causing Oscar to develop cerebral palsy, a seizure disorder and blindness. The Stearns’ first medical bill from their sons’ stay in the neonatal intensive care unit was $5.7 million. 

Stearns, a professor at the University of Mississippi, and her husband work full-time and have private insurance, which does apply to Oscar – but doesn’t address the gamut of his needs. 

“Commercial insurance is designed for helping when you’ve broken a leg, or you need your gallbladder removed,” Stearns explained. “It is not prepared to deal with long-term, intensive care needs.”

Oscar accesses Medicaid through what’s called a disabled child living at home waiver, which helps pay for nursing care and therapy for Oscar during school. It also pays for equipment and services that allow the Stearns to give their son care at home. Without it, Oscar would need to go to a pediatric nursing home – of which there are currently none in Mississippi, though one is projected to open in Jackson later this year. 

“Without the waivers, where can these kids and their families look for the support they need?” Stearns asked. “How can their parents hope to keep their families together and their children happy and healthy? How will Mississippi have failed them?”

One 9-year-old girl named Luciana gave testimony of how Medicaid helps her. She’s aware that the conditions she has – including autism and ADHD – are expensive. She says Medicaid saved her life during her stay in the NICU and now helps pay for medication that helps her think. 

“If I didn’t have my medicines I’d feel like a blank piece of paper without any drawings,” she told the crowd. 

Since Mississippi has not expanded Medicaid, advocates fear that any cuts to the federal program will affect the poorest of the poor, pregnant women, children, seniors and those with disabilities in Mississippi. 

“It is long past time to stop using the most vulnerable to subsidize the least vulnerable,” said Jayne Buttross of the disability coalition. 

The group will hold another rally on the south steps of the Capitol on March 18 at 1 p.m. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.