FMI Applauds Reintroduction of Bipartisan Medicaid PBM Reform Legislation

Bill Bans Spread Pricing and Ensures Fair and Transparent Pharmacy Reimbursement

Arlington, VA – Today, FMI – The Food Industry Association, representing supermarket pharmacies across the country, welcomed the bipartisan reintroduction of the Protecting Pharmacies in Medicaid Act - critical Medicaid pharmacy benefit manager (PBM) reform legislation aimed at increasing transparency and ensuring fair reimbursement for pharmacies serving Medicaid patients. The legislation, introduced by Sens. Roger Marshall (R-KS), Peter Welch (D-VT), Bill Cassidy (R-LA), and Mark Warner (D-VA), would prohibit PBMs from engaging in spread pricing in Medicaid managed care and require that pharmacies be reimbursed fairly for the cost of acquiring and dispensing prescription medications. FMI Chief Public Policy Officer Jennifer Hatcher offered the following statement: 

"For too long, PBMs have exploited opaque pricing models to drive up prescription drug costs while underpaying pharmacies, threatening their ability to serve communities and vulnerable populations. This legislation takes a crucial step toward correcting these unfair practices by requiring that 100% of the ingredient cost and professional dispensing fee be passed through to pharmacies. It also establishes much-needed reimbursement transparency to ensure pharmacies are fairly compensated for the essential care they provide. 

"Supermarket pharmacies are vital health access points for millions of Americans, particularly in underserved, rural, and urban communities. Yet, predatory PBM tactics have driven many of these pharmacies out of business, limiting patient access to medications and trusted pharmacy care. By eliminating spread pricing and tying Medicaid reimbursement to actual drug acquisition costs, this bill will help ensure that pharmacies can continue to serve Medicaid beneficiaries and their communities. 

“FMI thanks the bill sponsors for their leadership in advancing meaningful Medicaid PBM reform and looks forward to working with Congress to ensure its passage in the 119th Congress.”