Oregon lawmakers introduced new legislation aimed at regulating Pharmacy Benefit Managers (“PBMs”) doing business in the state. In February 2025, State Rep. Rob Nosse (D-Portland) introduced House Bill 3212, which is designed to support Oregon’s independent pharmacies. The bill comes after Rep. Nosse hosted a public session attended by numerous stakeholders including chain pharmacies, independent pharmacists, insurers and patient advocates. The purpose of the public session was to hear from industry professionals and citizens prior to introducing the new PBM legislation.
If enacted, House Bill 3212 will complement Oregon’s recently enacted PBM laws which all share the common goal of increasing the chances that independent pharmacies can stay in business. More specifically, House Bill 4012 and House Bill 4149, which took effect on January 1, 2025.
Oregon’s Independent Pharmacies Continue to Face Challenges
State Rep. Nosse has indicated that PBMs need more regulations to ensure independent pharmacies in Oregon remain financially viable. Over the last few years, Oregon’s independent pharmacies have been going out of business with chain pharmacies and mail order pharmacies taking their place, also leading to a decline of pharmacy access in certain underserved areas. Between 2021 and 2024, 74 independent pharmacies closed in Oregon. Oregon’s efforts over the past few years to help curtail this troubling trend seeks to reduce independent pharmacy closures in 2025 and beyond.
House Bill 3212 Attempts to Curb Unjust PBM Contracts
House Bill 3212 contains several provisions designed to support independent pharmacies and to limit or restrict some of the most troubling PBM business practices which include:
- Prohibiting PBMs from engaging in spread pricing;
- Requiring PBMs to pay a dispensing fee no less than the dispensing fee established by the Oregon Health Authority by rule;
- Requiring PBMs to offer the same contract terms to network pharmacies and out-of-network pharmacies, including reimbursing network and out-of-network pharmacies the same amount;
- Prohibiting PBMs from restricting pharmacies from discussing PBM contracts with other individuals and organizations; and
- Prohibiting PBMs from requiring pharmacies to provide services to a patient if the pharmacy will be reimbursed less than the pharmacy’s drug acquisition cost.
House Bill 4012 Prevents the Formation of Exclusive Pharmacy Networks
Another recently enacted law in Oregon that will help to support independent pharmacies is House Bill 4012. House Bill 4012 prevents health plans from limiting or denying coverage of a drug based on the enrollee’s choice of pharmacy or because the drug was not dispensed by a pharmacy that participates in the health benefit plan issuer’s provider network. This law is geared towards preventing the formation of exclusive pharmacy networks. Exclusive networks are often improperly used by PBMs created to steer patients to PBM affiliated pharmacies. This is a significant development to help limit and ultimately prevent patient steering in Oregon.
House Bill 4149 Allows Pharmacies to File Complaints Against PBMs
House Bill 4149, featured in a recent Frier Levitt article, increases reasonable PBM regulation by allowing pharmacies to file complaints against PBMs with the Department of Consumer and Business Services (the “Department”). The complaint process will allow an independent third-party, the Department, to monitor, prevent, and potentially penalize PBMs for any improper conduct under the applicable laws. PBMs are also now expressly prohibited from retaliating against pharmacies for utilizing and enforcing their rights by challenging PBM conduct whether it be by an audit appeal or filing a complaint with the Department. This is a significant development to help further restrict abusive PBM tactics.
Oregon’s Recent PBM Laws are a Positive Development, but More Must be Done
Oregon’s recent PBM laws and bills in the pipeline are a positive development for Oregon’s independent pharmacies, but pharmacy owners must remain vigilant and active in the legislation process. Oregon’s pharmacies and pharmacists should become familiar with Oregon’s PBM laws and should consider contacting their state legislators who are eager to develop new PBM laws and regulations. Without input from pharmacists and pharmacies on the ground level, legislators will not understand the unjust PBM tactics which force independent pharmacies to close.
How Frier Levitt Can Help
Frier Levitt represents numerous pharmacies across the United States in challenging PBM audits, network access, reimbursement practices and other complex issues such as DIR fees. Our attorneys have extensive knowledge in all aspects of the pharmacy-PBM relationship. Contact us to speak with an attorney about how your pharmacy can leverage the various applicable laws and protections afforded to pharmacies that regulate PBM conduct.
