Indiana Department of Insurance Hearing 12.08.2022
On Thursday, December 8th, the Indiana Department of Insurance held a rule hearing regarding proposed rule 760 IAC 5. Darren Covington, IPA Executive Vice President, and Veronica Vernon, IPA President, were able to attend the hearing and provide comments and concerns in benefit of the pharmacies across Indiana. The proposed rule aims to standardize Pharmacy Benefit Manager (PBM) practices across the state of Indiana, such as licensure and financial requirements, application and renewal fees, pharmacy claims audits, maximum allowable cost pricing, annual reporting and penalties for violation. You can read the rule in full here.
During the DOI rule hearing, Darren Covington testified, “PBMs were historically created to administer the pharmacy benefit of health plans and in doing so play an important and needed role in the health insurance space. But with the rise of vertical integration between health plans, PBMs and PBM-owned pharmacies, and consolidation of the market into a handful of multi-billion dollar businesses, there has come decreased reimbursements, opaqueness, and take-it-or-leave it contracting. The result has been truly detrimental to pharmacies and patients.” The Indiana Pharmacy Association travels across the state to small and large hospitals, independent pharmacies and multi-state chain pharmacies. All raise the issue of lack of transparency and fairness of pharmacy benefit managers. During the rule hearing Darren and Veronica testified about these concerns and presented them to the DOI in order to make the rule more beneficial toward pharmacies and make collaboration with the PBMs more successful in Indiana. The full text of Darren's remarks can be read here.