Video & Transcript Research : 'PBM'

Page 2 of 27
KY
Transcript Highlights:
  • <00:19:12.360> rebates the list price to afford PBM rebates the list price to afford PBM rebates
  • to their medical management plan pbms to their medical management plan pbms will<00:20:19.080>
  • In this example, the PBM negotiated price would be 52.
  • I would like to note we have talked about PBMs several times before.
  • It's section 12(d): it doesn't require insurers and PBMs to disclose detailed rebate information.
Summary: The House Standing Committee on Banking and Insurance met with a quorum and first took up Senate Bill 145, sponsored by Sen. David Givens. The bill would update retail installment contract statutes for automobile sales, allowing retailers with installment contracts shorter than 28 days to begin collections after three days instead of waiting for multiple missed payments, and it also harmonizes a related dollar amount in statute from $10 to $15. The committee asked no questions, and the bill received a favorable expression on a roll-call vote. The committee then heard Senate Bill 183 from Sen. Matt Nunn, with testimony from Chris Nolan of the American Property Casualty Insurance Association. The bill would require proxy advisers acting for the State Retirement System to act solely in the financial interest of current and future retirees and to avoid political or social considerations in shareholder voting recommendations. Supporters argued it would keep politics out of public pensions and align proxy advice with fiduciary duties; members praised the bill and noted Kentucky could be among the first states to adopt such a model. The committee approved the bill with favorable expression after a roll-call vote. The committee also reviewed administrative regulation 808 KAR 9:10 from the Department of Financial Institutions, with no vote required. It then took up House Bill 413, a PBM rebate pass-through bill, with testimony from Sarah Wood of the Diabetes Patient Advocacy Coalition. She said the bill would require 85% of negotiated drug rebates to be passed through to patients at the point of sale, lowering out-of-pocket costs, especially for high-rebate drugs such as insulin, while still allowing 15% to remain with plans. She cited examples from other states and argued the bill would benefit about 650,000 Kentuckians. Hope McClaflin of Anthem opposed the bill, saying it would reduce employers’ ability to use rebates to lower premiums, could disproportionately favor high-cost brand-name drug users, and could create significant costs for state and fully insured plans. Members asked questions about other states’ pass-through rates and the effect on premiums, but no final action on House Bill 413 was taken in the portion of the meeting provided.
ND

North Dakota 2025-2026 Regular Session

Senate Industry and Business Apr 2nd, 2025 at 02:45 pm

Industry and Business

Transcript Highlights:
  • Those are the sections of code that apply directly to PBMs.
  • Section 16 transfers the existing fund... ...the PBM regulation.
  • what would be turned over to the general fund for setting up and running the PBM regulation.
  • Section 1, where we do allow for the licensure not to exceed $10,000 for a PBM license.
  • However, you know, it's not uncommon for insurance commissioners to be regulating PBM.
Keywords: 908, all
Summary: The Senate Committee on Industry and Business reconvened to work on House Bill 1584, which would create a new pharmacy benefit manager (PBM) regulatory structure within the Insurance Department. Insurance Commissioner John Godfrey and Deputy Commissioner John Arnold explained a revised set of amendments negotiated with Representative Casper and the North Dakota Pharmacists Association. They said the bill largely kept the House policy intact but added technical corrections, narrowed some references in Chapter 19-02, created a separate PBM licensing class, set a delayed effective date for licensing, and established emergency authority so the department could begin building the new division. They also described the proposal to fund the program through existing trust fund resources, PBM license fees, and a transfer of about $1.6 million from the prescription drug transparency program fund, while allowing the department flexibility to hire needed attorneys, pharmacists, and examiners. A major point of discussion was Section 10, which would have required the Attorney General to represent and bear costs for lawsuits related to the bill. Chief Deputy Attorney General Claire Ness said the language was too broad and would go beyond normal constitutional defense work, potentially obligating her office to cover all lawsuits against the commissioner or state under the section. Representative Casper said the intent was only to avoid the Insurance Department having to seek emergency funding for litigation, and both he and department officials said they were open to removing the section or narrowing it. After further discussion, the committee agreed to remove Section 10 from the amendments. The committee then voted 4-0 to adopt the amended amendment package, and then voted 4-0 to give House Bill 1584 a do pass recommendation as amended and refer it to Appropriations. Members noted the bill was still a work in progress, but said the revised version was intended to move the PBM regulation issue forward while continuing discussion in the appropriations process.
OK

Oklahoma 2026 Regular Session

Senate Legislative Session Mar 26th, 2026 at 12:10 pm

Oklahoma Senate Floor Meeting

Transcript Highlights:
  • way as a pass-through PBM, a transparent pass-through PBM, that if those plans or those employers choose
  • We do PBMs play a role.
  • Our agency works with PBMs.
  • way as a pass-through PBM, a transparent pass-through PBM, that if those plans or those employers choose
  • Our agency works with PBMs.
MN

Minnesota 2025 1st Special Session

Committee on Health and Human Services - 03/18/25

Health and Human Services

Transcript Highlights:
  • reimbursed by MCO contracted PBMs. reimbursed by MCO contracted PBMs.
  • necessity and in peril due to PBM abuse. necessity and in peril due to PBM abuse.
  • The single PBM model dollars.
  • out of existence by the powerful PBMs. out of existence by the powerful PBMs.
  • You know, last year we talked about PBMs a lot. The year before that we talked about PBMs a lot.
Keywords: 1187, senate, all
OK
Transcript Highlights:
  • Members, Senate Bill 2074 is another PBM bill.
  • PBMs are an issue. They've been a problem.
  • They have the ability to negotiate a better deal with the PBM.
  • Is this not just on the state's portion of our PBM, the amount of money that... ...portion of our PBM
  • The PBMs are at record profits. The health insurers are at record profits.
MN

Minnesota 2025 1st Special Session

Committee on State and Local Government - 04/01/25

State and Local Government

Transcript Highlights:
  • dollars in overcharges by the PBM. dollars in overcharges by the PBM. 300,000<01:10:36.719> of
  • pharmacy benefit management or PBM pharmacy benefit management or PBM services.<01:11:39.840>
  • two, instead of creating more PBM two, instead of creating more PBM competition,<01:12:46.560>
  • All we're massive full-ervice PBM.
  • PBMs, excuse me,<01:15:25.679> PBMs<01:15:26.400> were<01:15:27.199> um, me, PBMs
Keywords: 1187, senate, all
TX

Texas 89th 2nd C.S.

Health Care Affordability, Select May 1st, 2026

Health Care Affordability, Select

Transcript Highlights:
  • and PBMs are now all cross-owned.
  • So the drug manufacturer has to pay a certain amount to the PBM for that PBM to offer the drug on the
  • the PBM than the insurance company.
  • PBMs are referred to as transparent PBMs because what happened in the past is who gets the rebate and
  • Currently, the PBM is Express Scripts, and Express Scripts is also the PBM for Health Select of Texas
Keywords: 1184, house, all
NH

New Hampshire 2026 Regular Session

House Commerce and Consumer Affairs (04/15/2026)

Commerce and Consumer Affairs

Transcript Highlights:
  • PBMs.
  • owns the PBM.
  • PBMs.
  • owns the PBM.
  • owns the PBM.
Keywords: 1189, house, all
AL

Alabama 2025 Regular Session

Alabama Senate Banking and Insurance Committee Mar 19th, 2025

Banking and Insurance

Transcript Highlights:
  • The PBM industry has never...
  • PBMs are middlemen that are profiting... ...PBMs are middlemen that are profiting while pharmacies around
  • The pharmacies are hurting under this broken PBM model that we desperately need to... ...PBM model that
  • Things that we've dealt with typically trace back to PBMs.
  • The most stressful part is dealing with the PBMs and trying to get the stuff that we... ...PBMs and trying
Keywords: 923, senate, all
TX
Transcript Highlights:
  • PBMs serve about 298 million Americans in this country. There are 66 PBMs that operate.
  • in rebates to plans and PBMs.
  • in rebates to plans and PBMs.
  • Specialty drugs by PBMs. PBMs determine this. Which one of you said that?
  • Specialty drugs by PBMs. PBMs determine this. Which one of you said that?
Keywords: 1185, senate, all
NH

New Hampshire 2025 Regular Session

Senate Health and Human Services (03/12/2025)

Health and Human Services

Transcript Highlights:
  • <00:54:04.160> and with um pbms and with um pbms and Contracting Contracting Contracting um
  • reach out to the PBM I will ask the PBM reach out to the PBM I will ask the PBM where<00:55:13.119
  • I will try to deal with the PBM.
  • What also came out this summer during our testimony before the PBM committee is these PBMs have 148 MAC
  • What also came out this summer during our testimony before the PBM committee is these PBMs have 148 MAC
Keywords: 1191, senate, all
TX
Transcript Highlights:
  • ERISA-based PBM plans follow state law. preemption, the U.S.
  • Variants of the PBMs are currently regulated by the PBMs right now, and that has not been born. to be
  • You know, PBMs are a problem.
  • The PBMs are playing both sides of the coin.
  • All PBMs are operating the same way in Texas.
TX
Transcript Highlights:
  • That opinion strengthens the regulatory framework for PBMs in Texas.
  • Will this impact PBM profits?
  • I do think that there is a growing concern of what PBMs have become.
  • And so I've heard both sides of a PBM being beneficial and then actually a PBM being excessive...
  • But there are problems with PBMs, and the PBM is embedded inside an...
FL

Florida 2026 4th Special Session

February 26, 2026 - 03:30 PM

Transcript Highlights:
  • for the elderly, so that they are not subject to the PBM law.
  • It prohibits a PBM from forcing pharmacies to take a loss on a drug, and it allows consolidated PBM claims
  • I think that focusing on the PBM and what we all intended to happen with PBMs a couple of years ago is
  • And then the PBMs negotiate with the retail pharmacies in secret.
  • It was a damning indictment of the practices of the PBMs.
TX

Texas 89th Regular

Health and Human Services (Part II) Mar 5th, 2025

Health & Human Services

Transcript Highlights:
  • Will this impact PBM profits?
  • That was how much the PBM paid its own pharmacy to dispense this medication.
  • A PBM is not allowed to pay its affiliated pharmacy more than another provider.
  • Would the PBM profit go down? Yes. Would it impact the employer? Absolutely.
  • And this is a PBM issue, you know, I can go down a rabbit hole on that, yes or no?
MS

Mississippi 2026 Regular Session

Public Health and Welfare - Room 216, 3 March, 2026; 3:00 PM

Public Health and Welfare

Transcript Highlights:
  • cost with PBM reform. cost with PBM reform.
  • we need PBM reform. we need PBM reform.
  • That's PBM reform.
  • This is PBM reform. it in there. This is PBM reform.
  • That's PBM reform. areas. That's PBM reform.
Summary: The committee first took up House Bill 1622, a strike-all amendment to create a pilot program for certain small-community hospitals to receive limited certificate-of-need exemptions. The bill would allow qualifying hospitals to open a geriatric psychiatric unit without a CON, permit each hospital one additional CON exemption for a service otherwise requiring one, cap dialysis-unit exemptions at eight hospitals, continue existing moratoriums with periodic Department of Health review, allow facilities in Issaquena or Humphreys Counties under limited conditions, and add a loser-pays rule for unsuccessful CON court challenges. Technical corrections were made, the strike-all amendment was adopted, and the bill was reported do pass as amended by voice vote. The committee then moved to House Bill 942, where Senator McMahan offered an amendment to allow a Lee County chiropractor to advertise as a neurologic chiropractor and list related credentials. Members questioned whether chiropractic neurology is recognized in Mississippi and raised concerns about the practitioner’s prior discipline by the board, but the chair ruled the amendment germane. The amendment failed on voice vote, and the bill itself then passed and was reported to the floor. The committee next considered House Bill 1034, but no amendment was offered. It then took House Bill 479 off the table. That bill extends the temporary licensing period for psychology and marriage-and-family-therapy boards from 30 to 60 days to allow more time for criminal background checks. Senator Blackwell offered a clarifying amendment to make clear that temporary licenses must be revoked if required background checks or other licensure requirements are insufficient, and that the temporary license does not replace the underlying education, training, and examination requirements. The amendment was adopted and the bill was reported do pass as amended. Finally, the committee heard House Bill 1067, the Rural Health Transformation Program. Senator Hickman explained that the bill would require procurement procedures and reporting for the state’s rural health transformation funds, prioritize projects tied to the original application, and direct funds toward rural and underserved areas such as health professional shortage areas, low-income counties, and places without hospitals. Senators questioned whether the added state rules would layer on top of existing federal requirements and whether the bill could slow distribution or invite litigation, but supporters said it was meant to add transparency and guardrails rather than change the federal program. The bill was discussed at length, but the transcript ends before a final vote on HB 1067.
MN

Minnesota 2025-2026 Regular Session

Committee on Health and Human Services - 04/08/26

Health and Human Services

Transcript Highlights:
  • Pharmacy Reimbursement and PBM Pharmacy Reimbursement and PBM Transparency<01:16:07.880> Act.
  • It reins in the predatory practices of PBMs.
  • It reins in the predatory practices of PBMs.
  • Senate between the PBM and the pharmacy.
  • where you have to be a national PBM where you have to be a national PBM chain<01:48:09.640> something
Keywords: 1187, senate, all
TX

Texas 89th Regular

Health and Human Services Apr 1st, 2025

Health & Human Services

Transcript Highlights:
  • Senate Bill 1236, Pharmacy Benefit Managers, PBMs,” “Senate Bill 1236, Pharmacy Benefit Managers, PBMs
  • by allowing refills only to be filled by PBM-owned mail-order pharmacies.
  • There are some great PBM laws already on the books.
  • The amount paid by the PBM for the actual medication was over $2,800.
  • I remember what the spend was supposed to be on PBMs.
Summary: The committee heard testimony on Senate Bill 883, which would protect physicians’ ability to prescribe off-label medications and treatments, framed by the author as a “Right to Treat” measure tied to COVID-19 care. Supporters, including physicians and patient-choice advocates, said the bill would safeguard the doctor-patient relationship and prevent interference by boards, pharmacies, or hospitals. Several witnesses described using hydroxychloroquine, ivermectin, budesonide, antibiotics, steroids, and monoclonal antibodies during the pandemic, and said they faced complaints, board scrutiny, or pharmacy refusals for those prescriptions. The bill was left pending after public testimony closed. The committee then took up Senate Bill 331, which would extend hospital price-transparency requirements to additional health care facilities such as freestanding ERs, urgent care and retail clinics, ambulatory surgical centers, outpatient clinics, and birthing centers. Proponents argued that broader disclosure of prices for shoppable services would help consumers compare costs and reduce surprise billing, while opponents from ambulatory surgery centers said the bill would impose costly compliance burdens on small providers and that insurers or the state already have much of the needed data. The bill was also left pending. Senate Bill 2422 would expunge Texas Medical Board records and impose reparations for disciplinary actions tied to COVID-era treatment decisions, including references to ivermectin, hydroxychloroquine, budesonide, and masks. The author and supporters argued that doctors were unfairly targeted for trying to save patients and should be made whole; the Texas Medical Board representative said most pandemic complaints were dismissed, that actions generally involved broader issues such as privileges, documentation, or informed consent, and that no physician was disciplined solely for prescribing off-label COVID medications. The bill was left pending. Finally, the committee heard Senate Bill 2207, which would loosen Texas Medical Board rules on physicians advertising themselves as board certified, especially by reducing barriers tied to maintenance of certification requirements. Supporters said the current rule is overly restrictive, inconsistent, and costly, and that it drives physicians out of practice; they also said Texas is one of only a few states with such a rule. Witnesses described hospitals using the rule against physicians and said the change would improve transparency and competition. The bill remained pending after testimony.
NH

New Hampshire 2026 Regular Session

Senate Health and Human Services (01/21/2026)

Health and Human Services

Keywords: 1191, senate, all
NM

New Mexico 2025 Regular Session

IC - Legislative Health and Human Services Jul 22nd, 2025

Legislative Health & Human Services Committee

Transcript Highlights:
  • We would actually recommend that you unbundle PBM services.
  • The whole concept is to completely unbundle what PBMs do.
  • Or is there something we could do with the PBMs?
  • So on slide 11, you mentioned PBM alternatives, but in other states, those PBM alternatives have just
  • And then, a recommendation to enhance PBM oversight.