House Passes Pharmacy Reimbursement Bill

ATLANTA— The Georgia House of Representatives passed House Bill 179 on Friday, February 22, 2013, by a unanimous vote of 161-0. Sponsored by state Representative Andy Welch (R–Locust Grove), HB 179 would remove a penalty from current law that costs pharmacies thousands of dollars for minor clerical errors.

“The current penalties for clerical errors are harmful to independent pharmacies across the state,” said Rep. Andy Welch. “I decided to introduce HB 179 after this problem was brought to my attention by Loren Pierce, the owner of Moyes Pharmacy, an independent pharmacy chain in Henry County.”

Current law penalizes pharmacists for making any clerical mistakes in the paperwork for filling a prescription. If the Pharmacy Benefit Manager (PBM) catches any such error during a routine audit, the pharmacist must pay the PBM for the full cost of the prescription that was incorrectly filed. Pharmacists must pay this amount even if there was no over-dispensing or other actual cost caused by the error.

HB 179 would reduce this penalty by allowing pharmacists 30 days to appeal the audit decision of the PBM, and prove that the error was a mistake in paperwork that did not result in any actual cost or medical harm.

Pharmacy Benefit Managers (PMBs) function as middlemen between customers and all other organizations within healthcare. PBMs usually make most of their money through service fees from large contracts with insurance companies or corporations for processing prescriptions, or operating pharmacies. PMBs also negotiate with drug producers and pharmacies, and will use their size as leverage for their clients.

For more information on HB 179, please click here.

Representative Andrew Welch represents the citizens of District 110, which includes portions of Butts, Henry, and Newton Counties. He was elected into the House of Representatives in 2010, and currently serves as the Vice-Chairman on the Code Revision Committee. He also serves on the Judiciary, Juvenile Justice, and Regulated Industries committee.