APCI Press Releases


Georgia Lawmakers Speak Out on Reimbursement Discrepancies

Author: APCI Staff/Wednesday, February 21, 2024/Categories: APCI News, Legislative Affairs

Like most independent pharmacy owners, Katie Bell faced unrelenting financial pressures at her pharmacy because of below-cost reimbursements from PBMs and health plans for far too many of the prescriptions she dispensed. The reimbursement rates were so unsustainable that she was forced to close Bell’s Family Pharmacy in Tate, Ga., late last week.

However, Bell’s misfortune – and the rates at which she was being reimbursed – may bring to light many of the unfair PBM practices plaguing independent pharmacies across the country.

As part of PBM reform efforts in Georgia, APCI’s Greg Reybold in conjunction with the Georgia Pharmacy Association shared publicly-available data with members of the Georgia Legislature that showed the stark contrast between what the Georgia State Health Benefit plan – whose prescription benefits are managed by CVS Caremark – reimbursed Bell’s Family Pharmacy for medications it dispensed versus what the plan paid to chain pharmacies. The difference is stark.

APCI and GPA reimbursement discrepancy handout

Click on the image above to open a full-size, downloadable PDF file

The reaction from lawmakers was swift, heartfelt – and angry. Lawmakers took to the House floor on Tuesday, Feb., 20, to offer comments on the reimbursement discrepancies and what it means to independent pharmacies in the state. You can view their comments below:

These Georgia representatives are the kind of champions independent pharmacy must have if the industry is to survive. As our hometown independent pharmacies continue to shutter their doors because of this unsustainable business model, it is incumbent on all of us – pharmacy owners, staff members, patients, and taxpayers – to urge our elected officials at both the state and federal levels to rein in unfair and abusive PBM practices.