Pa. Senate proposal targets pharmacy benefit managers

It’s viewed as a way to ease financial pressures on pharmacies throughout the state.

State lawmakers representing Southwestern Pennsylvania say a forthcoming proposal targeting pharmacy benefit managers could strengthen oversight and help stabilize access to prescription medications as closures continue to affect local communities.

State Sens. Wayne Langerholc Jr., Judy Ward and Pat Stefano announced plans to introduce legislation that would expand regulation of pharmacy benefit managers, commonly known as PBMs, who serve as middlemen between insurers, pharmacies and drug manufacturers.

A co-sponsorship memo outlining the proposal circulated among members of the Pennsylvania Senate in February, and the legislation remains in the pre-introduction phase as sponsors continue to gather support.

The bill has not yet been formally introduced and has not been assigned to a committee.

PBMs manage prescription drug benefits for insurers, employers and government programs and play a key role in setting reimbursement rates and negotiating prices.

Lawmakers said the new proposal builds on reforms enacted under Act 77 of 2024, which aimed to increase transparency, but they argue, did not go far enough to address ongoing concerns.

Under the proposal, the Pennsylvania Office of Attorney General would gain authority to review all contract renewals and terminations between pharmacies and PBMs to determine how those decisions impact patient access, particularly in underserved areas.

The measure would also empower the attorney general to pursue legal action against PBMs on behalf of the commonwealth and its residents, authority the office currently does not hold.

Additional provisions would require PBMs to appear in Pennsylvania courts for disputes tied to in-state actions, a move supporters say would prevent pharmacies and patients from being forced to litigate out of state.

The legislation also calls for administrative changes.

The state Board of Pharmacy would be required to notify PBMs of disciplinary actions taken against pharmacies by the board or the U.S. Drug Enforcement Administration, and PBMs would be prohibited from holding a pharmacy license in Pennsylvania.

Lawmakers said the bill would expand protections created under Act 77, including provisions preventing pharmacies from being removed from PBM networks solely for completing corrective action plans.

Stefano said concerns about PBM practices have been raised repeatedly by residents and independent pharmacy owners.

“Across our rural communities, we have consistently heard from constituents and businesses about the serious challenges that pharmacies are facing,” Stefano said. “My focus continues to be on protecting access to care and supporting our community- based pharmacies, which are vital to our area’s health and well-being.”

The proposal comes as pharmacy closures continue to reshape access across the Mon Valley. Several Rite Aid locations, including stores in Monessen, Charleroi and Rostraver Township, have shuttered in recent months as part of the company’s ongoing bankruptcy proceedings, leaving some residents with limited local options for prescriptions.

Ward said those closures highlight the importance of addressing PBM practices.

“Many pharmacies, especially community pharmacies, have closed their doors because of unfair PBM practices,” Ward said. “These patients are left without adequate access and now must drive great distances to have a prescription filled.”

Langerholc said lawmakers have been reviewing the issue for months and determined additional reforms are needed.

“The residents of the commonwealth should not have their essential prescriptions held hostage due to a contractual dispute,” he said.

While the proposal has not yet been formally introduced, lawmakers said they expect to bring the bill forward where it would then be referred to a Senate committee for consideration.