Hotly contested legislation that aimed to increase the transparency and regulation of pharmacy benefit managers appeared dead in the water Tuesday after a lawmaker challenged the bill for a rule violation.

The bill was sent back to conference after Rep. John Hines, D-Greenville, raised a point of order challenging the addition of code sections to the bill, which will likely kill it. 

House members in the past have chosen to turn a blind eye to the rule, which would require the added code sections to be removed when the bill is returned to conference. This fatal flaw will make it difficult to revive the legislation. 

“It will almost certainly die,” said House Speaker Jason White, who authored the legislation. “And you can celebrate that with your pharmacist when you see them.”

“…This wasn’t ‘gotcha.’ Everybody in this chamber knew that code sections were added, because the attempt was to make 1123 more suitable to all the parties.”

The bill sought to protect patients and independent pharmacists, who have warned that if legislators do not pass a law this year to regulate pharmacy benefit managers, which serve as middlemen in the pharmaceutical industry, some pharmacies may be forced to close. They say that the companies’ low payments and unfair business practices have left them struggling to break even.

The bill underwent several revisions in the House and Senate before reaching its most recent form, which independent pharmacists say has watered the bill down and will not offer them adequate protection. 

House Bill 1123, authored by White, originally focused on the transparency of pharmacy benefit managers. The Senate then beefed up the bill by adding provisions barring the companies from steering patients to affiliate pharmacies and prohibiting spread pricing – the practice of paying insurers more for drugs than pharmacists in order to inflate pharmacy benefit managers’ profits. 

Independent pharmacists, who have flocked to the Capitol to advocate for reform this session, widely supported the Senate’s version of the bill. 

The Senate incorporated several recommendations from the House into its bill, saying that they believed that the legislation would have the House’s support. 

Instead, the House sent the bill to conference and requested additional changes, including new language that would eliminate self-funded insurance plans, or health plans in which employers assume the financial risk of covering employees’ health care costs themselves, from a section of the bill that prohibits pharmacy benefit managers from steering patients to specific pharmacies.

This language seeks to satisfy employers, who argue that regulating pharmacy benefit managers’ business practices will lead to higher health insurance costs. 

Sen. Rita Parks, R-Corinth, who has spearheaded pharmacy benefit manager reform efforts in the Senate, previously said that adding the language to the bill would “remove any protection out of the law.” But she signed the conference report that included the language Monday after a heated conference meeting between lawmakers. 

Rep. Hank Zuber, R-Ocean Springs and co-author of the bill, said the bill has something for everybody, gesturing to its concessions for employers and independent pharmacists. He said the bill gives independent pharmacists 85% of what they wanted. 

Mississippi Independent Pharmacies Association director Robert Dozier was not available for comment by the time the story published. 

Zuber told House members Tuesday to “blame the Senate” for the slow progress of pharmacy benefit manager reform in Mississippi, citing the body’s failure to take up a drug pricing transparency bill half a decade ago, for three years in a row.

“If the Senate had followed the leadership and the legislation that we drafted those many years ago, we would not be here,” Zuber said. “We would have the information on drug pricing, we would have the information and transparency on (pharmacy benefit managers) and we would have the ultimate reason as to why drug costs continue to rise.”

Members of the House expressed dissatisfaction with the legislation Tuesday, arguing it did not do enough to ensure lower prescription drug costs for consumers. 

“I’m going to try to do something next year that goes even further,” Zuber responded.

For the past several years, lawmakers have proposed bills to regulate pharmacy benefit managers, but none have made it as far as this session. 

“We’ll go another year,” said White. 

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