On March 24, 2025, Virginia’s Governor, Glenn Youngkin, signed the Save Local Pharmacies Act (“Act”) into law after it previously passed the House and Senate. The bipartisan support the Act received in the House and Senate was a major development for Virginia’s independent pharmacies and seemingly led to Governor Youngkin’s decision to sign the Act into law. As Frier Levitt discussed in a prior article, the Act aims to rehabilitate Virginia’s pharmacy deserts which has been a concern in Virginia (and throughout the country). Pharmacy deserts are typically considered to be areas where there is limited, or in extreme cases no, access to pharmacies. The decline of independent pharmacies, particularly in Virginia’s rural areas, is largely due to significantly low reimbursements from Pharmacy Benefit Managers (“PBMs”) managing Virginia’s Medicaid program, which has forced many independent pharmacies to close. To address this serious issue, Virginia, through the Act, seeks to replace the current system of multiple PBMs with a single PBM. Virginia’s Medicaid program currently reimburses pharmacies an average of $1.09 per prescription, which is well below the $10.65 average cost to dispense each prescription.
The Act is designed to realign Virginia’s Medicaid pharmacy benefits with the goal of providing greater support for Virginia’s independent pharmacies in the following ways:
- Allow direct state contracting for prescription benefits. The Act would eliminate having multiple PBMs as middlemen in the Medicaid prescription process, allowing Virginia to streamline oversight for cost efficiency and patient care while also ensuring access to pharmacy benefits in Virginia’s communities;
- Consolidate to just one PBM leading to reduced administrative fees and focused oversight of the formulary, pricing negotiations, and rebates;
- Provide the Department of Medical Assistance Services (“DMAS”) access for drug pricing, rebates, and administrative costs disclosed for analysis; and
- Task the new PBM with protecting pharmacy access for residents, particularly in underserved areas.
Now that the Act has been signed into law, it is projected to save Virginia at least $39 million annually. Virginia’s pharmacies and pharmacists should become familiar with the Act.
How Frier Levitt Can Help
Frier Levitt represents numerous pharmacies across the United States assisting them in challenging PBM audits, network access, reimbursement practices (including DIR fees and MAC reimbursement) and providing extensive knowledge on all aspects of the pharmacy-PBM relationship. Contact us to speak with an attorney about how your pharmacy can leverage the various laws and protections afforded to pharmacies, including PBM laws throughout the country in states like Virginia.
