State Rep. Thomas West (D-Canton) today responded to reports that a number of Pharmacy Benefit Managers (PBMs) have been charging Ohio taxpayers three to six times as much as the industry standard to process prescription drugs for Ohio Medicaid recipients. For prescriptions that should cost between 95 cents and $1.90, PBMs CVS Caremark and Optum Rx have been charging Ohio taxpayers $5.60 and $6.50 per script, respectively.
“Taxpayers are being swindled by corporate PBMs who try to bully, intimidate and claw-back money from hardworking people,” said West. “We cannot continue to give handouts to these corporations who put profits over sick, disabled and low-income Ohioans. We need to continue to look into ways to ensure the people of Ohio get a fair deal for their prescription drugs.”
The Ohio House Wednesday passed House Bill 479, Rep. West’s bipartisan bill to crack down on PBMs by prohibiting gag rules that prevent pharmacists from informing consumers when they are overpaying for prescription drugs—a move that could put millions back into the pockets of Ohio consumers.
“We passed House Bill 479 to put money back in the pockets of hardworking Ohioans and keep independent pharmacies from being run out of business by unscrupulous PBMs,” added West. “I urge my Senate colleagues to take up this legislation immediately so we can put hard-earned money back into the hands of working families.”
West also recently called for the delayed implementation of the second phase of the state’s planned Behavioral Health Redesign, following recent survey results that shows more than 60 percent of healthcare providers have been shortchanged by Medicaid since the implementation of the redesign plan in January. Drastic cuts have forced a number of providers to lay off employees, eliminate services and deny patient claims.
“This botched rollout has been a headache for providers and patients alike. We cannot continue to follow a plan that threatens healthcare access and forces providers to eliminate staff and cut essential services,” said West. “In my district right now, the Crisis Center and the Domestic Violence Project have told me they’ve already had to cut services. At a time when opioids continue to ravage our neighborhoods, we need to do everything we can to expand access to quality, affordable healthcare, not endanger it.”
Across the state, more than 50 percent of providers have had to tap into cash reserves to cover expenses. Denied claims for patients have more than doubled since the implementation of Phase I in January 2018. Phase II of the plan is scheduled to take effect July 1.
“It all comes down to people,” said West. “When prescription drugs prices soar and healthcare access is cut off, people suffer. We need to get back to a system that values people over profits. That’s what this fight is all about.”