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From YouTube: House Insurance Committee- March 23, 2021
Description
House Insurance Committee- March 23, 2021
A
B
A
A
A
C
You,
mr
chairman,
the
amendment
prevents
a
pbm
or
third-party
payer
from
discriminating
as
against
a
340b
entity
by
requiring
requiring
they
add
a
claims
modifier
for
the
sole
purpose
of
the
identification
of
340b
claims.
This
modifier
unnecessarily
exposes
340b
pharmacies
to
additional
transaction
and
administrative
fees
as
well
as
clawbacks
associated
with
delayed
claim
submissions.
A
D
A
D
Thank
you,
mr
chairman
and
committee.
This
is
a
reporting
bill
that
creates,
through
the
department
of
commerce
and
insurance,
a
tied
to
the
licensure
of
a
pharmacy
benefit
manager,
a
complaint
or
a
submission
process
for
patients,
as
well
as
pharmacists
that
are
using
a
pharmacy
benefit
manager
benefit
package
in
the
particular
state.
In
our
state.
We
have
a
currently
the
licensure
on
an
every
other
year.
Basis
is
one
hundred
dollars.
This
particular
bill
would
increase
that
to
one
thousand
dollars
and
then
the
renewal
on
thereafter
after
the
original
licensure
is
currently
fifty
dollars.
D
It
would
increase
it
to
500
so
that
we
would
have
operating
expenses
covered
for
the
investigator
and
or
person
for
the
complaints,
and
essentially
this
ensures
that
a
patient's
interest
or
primary
when
it
comes
for
prescriptions
and
their
coverage
and
when
a
particular
patient
has
a
problem
with
their
pharmacy
benefit
manager
or
their
pharmacy
benefit.
This
gives
them
a
way
to
report
that
and
work
through
a
remedy,
and
with
that,
mr
chairman
I'll,
be
happy
to
take
questions.
E
Thank
you
thank
you
and
chair
lady
smith,
in
in
in
the
summary
of
the
bill
it
talks
about,
requires
pharmacy
benefit,
managed
managers
to
demonstrate
that
the
best
interests
of
the
insured
have
been
prioritized
above
the
interest
of
other
parties.
Can
you
just
give
us
a
scenario
of
how
they
would
do
that.
D
D
In
the
particular
case
of
a
physician
making
a
prescribing
decision,
that's
about
care,
and
in
this
particular
time
it
would
be
making
sure
that
if
a
complaint
is
issued,
the
department
has
at
their
disposal
a
process
which
they'll
promulgate
their
own
rules.
They
must
determine
which,
in
this
particular
case,
in
a
complaint
by
complaint
basis,
we're
not
putting
anything
into
code
that
would
limit
the
the
definition
to
one
or
the
other.
D
But
in
this
particular
case,
if
the,
if
the
department
views
that
coverage
is
the
question,
then
the
the
insurance
company
could
make
that
decision
best.
If
it's
an
in,
if
it's
a
decision
decision
that
a
care
issue
is
in
in
in
question,
then
they
make
that
determination
as
well,
but
this
would
just
set
up
the
construct
for
that
process
to
occur
and
it
gives
the
department
of
commerce
and
insurance
the
ability
to
choose.
Is
this
a
question
between
what's
best
as
far
as
coverage
or
what's
best
as
far
as
care.