The Washington House of Representatives unanimously passed HB 1813, a patient choice bill, this month. Among other patient protections, the bill would address PBM conflicts of interest by prohibiting a PBM from requiring a patient to utilize a mail-order pharmacy and from reimbursing PBM-affiliated pharmacies at higher rates than non-affiliated pharmacies. HB 1813 now heads to the state Senate for consideration.

Pharmacy groups applauded a victory for pharmacies and patient access to care when the Western District of Washington approved a motion seeking to remand an unlawful, below-cost Medicaid pharmacy reimbursement plan in Washington state back to the CMS. The lawsuit challenging the plan brings up concerns that it may jeopardize the vitality of independent pharmacy businesses and their patients' health access. The CMS is being urged to consider actual pharmacy operation costs associated with filling prescriptions and take that into account when determining a fair reimbursement rate.

On January 19, 2021, the Center for Medicare & Medicaid Services (CMS) approved a move by Washington State to reimburse pharmacies for Medicaid patients far below the actual cost of dispensing prescriptions. Now, the Department of Justice (who represents CMS) makes a motion to remand the decision back to CMS and reconsider the matter entirely. This marks a step forward in getting independent pharmacies the reimbursements they deserve.