By Sen. Judy Ward (R-30), Sen. Christine Tartaglione (D-2), Rep. Jessica Benham (D-36) and Rep. Valerie Gaydos (R-44)
It’s hard to believe that right now, in the 21st century, countless Pennsylvanians are losing access to affordable prescription drugs. But that’s exactly what’s happening as more and more community pharmacies are being forced to close their doors due to the little-known role pharmacy benefit managers (PBMs) play in our health care system.
Because of PBMs, our commonwealth’s community pharmacies are faced with Medicaid reimbursement costs that do not cover the expenses incurred to purchase drugs. For some of our pharmacies, this challenge threatens their very survival.
PBMs were created with the best intentions to negotiate pricing with drug companies for prescription drugs through Medicaid to lower costs. But today, three PBMs — CVS Caremark, Express Scripts and Optum Rx — control 80% of the marketplace. With the big three in place, Pennsylvania’s Medicaid spend on the pharmacy benefit has drastically increased, from $1.41 billion in 2013 to $3.7 billion now annually, according to the National Community Pharmacy Association (NCPA).
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In February, Mainline Pharmacy announced PBM pricing was forcing the closure of nine of its pharmacies in the greater Pittsburgh region across several counties, including Blair, Cambria and Westmoreland. This happened despite a record year for filling prescriptions because they lost $350,000 in the first six weeks of this year from PBM underpayments. Philadelphia lost several community pharmacies in underserved communities, including the 18th Street Apothecary and Haussemann’s Pharmacy.
We’re seeing this issue repeated across the commonwealth and the nation. The University of Pittsburgh has created a website (ActForPharmacy.com) that tracks community pharmacy closures and provides a sobering view of the challenges Pennsylvania community pharmacies face in staying open — and of Pennsylvanians who desperately need their prescriptions.
That’s why we’re sponsoring bipartisan legislation in the state House (House Bill 1993) and Senate (Senate Bill 1000) to stop this vicious cycle and bring transparency to the process. Transparency is critical to solving this problem because no one really knows how much PBMs are making at the expense of Pennsylvania’s dedicated community pharmacies and their patients.
We’re pleased the need for PBM reforms was cited by Gov. Josh Shapiro in his recent state budget address. Our legislation will direct the state Insurance Department to develop a process for hearing and resolving pharmacy complaints against a PBM. It also will require PBMs to report financial information on rebates and payments received from drug manufacturers and how those rebates and payments were distributed by the PBM. In addition, the legislation will limit or ban several practices by PBMs, including patient steering and spread profit schemes.
The time to enact comprehensive PBM reform is now. Nationally, the issue is taking center stage. A recent White House roundtable on lowering health care costs and bringing transparency to prescription drug middlemen included Pennsylvania pharmacist Dr. Chichi Ilonzo Momah, CEO and founder of Springfield Pharmacy in Delaware County. Speaking for community pharmacists, Dr. Momah detailed what’s happening to community pharmacists and the negative impact PBMs have on the Pennsylvania patients they serve.
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Also at the roundtable was billionaire philanthropist Mark Cuban, a co-host of Shark Tank and owner of the NBA’s Dallas Mavericks. An outspoken critic of PBMs, Cuban has formed Cost Plus Drug Company, which provides complete price transparency from manufacturing to prescription delivery.
Let’s stop the needless closure of any more community pharmacies. Pennsylvania has the ability to better protect our commonwealth’s pharmacies, which are vital to their communities through the jobs they create and Pennsylvania families who depend on them for their prescription medications.
Republican Sen. Judy Ward represents Blair County and Democrat Christine Tartaglione represents parts of Philadelphia. Democratic Rep. Jessica Benham and Republican Rep. Valerie Gaydos represent parts of Allegheny County.
White House:https://www.whitehouse.gov/briefing-room/statements-releases/2024/03/05/readout-of-white-house-roundtable-on-lowering-healthcare-costs-and-bringing-transparency-to-prescription-drug-middlemen/
More than $22 million in “Money Match” checks were mailed to nearly 100,000 Pennsylvanians, the treasury said.
In a news release on Thursday, the Pennsylvania Treasury said people should be on the lookout for the checks, which are part of the Pennsylvania Money Match program. Treasurer Stacy Garrity said to cash or deposit the checks “promptly.”
The first Pennsylvania Money Match checks, totaling more than $1.7 million, are now on the way to Pennsylvanians’ mailboxes. Pennsylvania Money Match is a new program that allows Treasury to return certain unclaimed property to rightful owners automatically, which was approved unanimously by the General Assembly and signed by the Governor last year.
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“I want Pennsylvanians to know that this is a real check, it is real money, and it belongs to them,” Garrity said in the news release. “And as always, I still encourage everyone to regularly search for unclaimed property online, as many claims will not qualify for the Money Match process.”
With the mailing of the year’s last batch of checks, more than $50 million will have been returned automatically to Pennsylvanians.
What are Money Match checks?
The program allows the state treasury to automatically return unclaimed property valued up to $500 owned by a single individual. Before the program was created in 2024, residents themselves had to seek out unclaimed property.
“I’m thrilled to continue this program as we work hard to get more money back to its rightful owners,” Garrity said in the news release.
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However, if the property has multiple owners or is valued higher than $500, Pennsylvanians still need to file a claim.
What is unclaimed property?
Unclaimed property includes dormant bank accounts, uncashed checks, forgotten stocks, rebates and insurance policies, among other things. It can also include the contents of abandoned safe deposit boxes.
According to the state treasury, more than one in 10 Pennsylvanians is owed some of the $5 billion in unclaimed property in the treasury’s care, and the average value of a claim is more than $1,000.
Unclaimed property scam
On its website, the state treasury has a warning about scammers using text messages to target potential unclaimed property claimants.
The department “never reaches out to people in regard to any program, including unclaimed property, via unsolicited text messages.”
A special weather statement was issued by the National Weather Service on Friday at 10:06 a.m. until 1 p.m. for Warren, McKean, Elk, Cameron, Clearfield, Cambria and Somerset counties.
“Temperatures will drop below the freezing mark through midday with rain showers quickly changing to snow showers. Blustery winds may dry off roads and other paved surfaces, but any residual water from previous rain or melting snow could freeze up and result in slick spots through the afternoon,” explains the weather service.
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