State Rep. Seth Grove | Pennsylvania 196th Legislative District
State Rep. Seth Grove | Pennsylvania 196th Legislative District
Harrisburg – The following statement is issued on behalf of House Republican Leader Bryan Cutler (R – Lancaster) and House Republican Appropriations Chairman Seth Grove (R – York):
House Republicans have worked in a bipartisan way to reduce the cost of prescription drugs by eliminating spread pricing and reigning in Pharmacy Benefit Managers (PBM) fees. Auditor General Timothy DeFoor’s report reveals more government waste on an issue which should have been resolved, a troubling trend in state government.
Rep. Doyle Heffley (R – Carbon) eliminated the practice of spread pricing and required transparency on transmission fees charged by the PBMs to pharmacies. The Auditor General’s report shows that the Department of Human Services (DHS) failure to fully follow Act 120 is costing taxpayers millions of dollars. In response to the report, DHS acknowledged that they have the ability to audit PBMs; however, they chose to push that responsibility to the managed care organizations (MCOs).
Further, while transmission fees charged by the PBM are required to be disclosed and applied at the time of adjudication of a pharmacy claim, they are not deducted from the MCO reported costs utilized to calculate capitated payments, allowing PBMs to further inflate the cost of prescription drugs and profit at the detriment of the Commonwealth’s taxpayers.
House Republicans have been at the forefront of the fight to restrain secretive costs implemented by PBMs, first through Act 120, and most recently from Rep. Valerie Gaydos (R – Allegheny). With inflation driving up costs over the last three years – including prescription drugs – it is crucial that immediate steps be taken to save money. Auditor General Timothy DeFoor has identified several recommendations that DHS should urgently consider not only to comply with existing law but also to further address transparency and ballooning costs in Medicaid.
Press Inquiries:
Rep. Cutler: Mike Straub mstraub@pahousegop.com or 717-260-6397
Rep. Grove: Charlie O’Neill coneill@pahousegop.com or 267-303-7028
Representative Seth Grove
196th District
Pennsylvania House of Representatives
Media Contact: Charlie O’Neill
717-260-6121
coneill@pahousegop.com
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