PHARMACY ALERT: Connecticut’s Law Prohibiting Post-Point-of-Sale Fees in PBM Contracts Now in Effect
A new law in Connecticut provides independent pharmacies with extraordinary relief against Pharmacy Benefits Managers (“PBMs”), and various post-point-of-sale fees like Direct and Indirect Remuneration (“DIR”) and Generic Effective Rates (“GER”) that are common in PBM contracts with pharmacies. On January 1, 2020, C.G.S.A. § 38a-477cc(a)(1)(B) went into effect. That law prohibits a health carrier or PBMs from
Recoup[ing], directly or indirectly, from a pharmacy or pharmacist any portion of a claim that such health carrier or pharmacy benefits manager has paid to the pharmacy or pharmacist, unless such recoupment is permitted under section 38a–479iii or required by applicable law.
This law provides momentous protection for independent pharmacies in Connecticut, as it can potentially save Connecticut pharmacies millions of dollars, not only by preventing PBMs from levying these fees, but by allowing pharmacies to take back fees PBMs have already collected in violation of the law. Moreover, the State’s Unfair Trade Practices law allows pharmacies to seek punitive damages for PBMs’ egregious activity and seek other remedies that will prevent PBM conduct like this in the future.
Frier Levitt’s attorneys have decades of expertise in fighting abusive PBM practices and can leverage these and other laws to reverse PBM abuses like DIR and GER fees, among others. Contact Frier Levitt today to discuss options for your pharmacy.