Something to Envy: South Carolina Tackles Drug Benefit Management

| Aaron Turner-Phifer
Drug law concept. Judges gavel with stethoscope and pills close up

Last month South Carolina Governor Henry McMaster signed into law a measure regulating the practice and oversight of drug benefits, including pharmacy benefit managers (PBMs), in the state.

Senate Bill 359 requires PBMs to be licensed by the state’s Department of Insurance, increases reimbursement transparency by limiting retroactive fee and claim adjustments, and seeks to maintain competitive balance among pharmacies.

This legislative measure also recognizes the important role pharmacy accreditation plays in the protection of prescribed complex, expensive medications. The law states:

(E) A pharmacy benefits manager may maintain more than one network for different pharmacy services. Each individual network may require different pharmacy accreditation standards or certification requirements for participating in the network provided that the pharmacy accreditation standards or certification requirements are applied without regard to a pharmacy's or pharmacist's status as an independent pharmacy or pharmacy benefits manager affiliate. Each individual pharmacy location as identified by its National Council for Prescription Drug Program identification number may have access to more than one network so long as the pharmacy location meets the pharmacy accreditation standards or certification requirements of each network.

South Carolina’s move to increase oversight of PBMs and pharmacies in the state should serve as a model for other states. As federal lawmakers and many state policy makers have struggled to meet the public’s demand for action on drug prices and the management of their drug benefits. All too often inaction is the result of a divided among political and party lines.

South Carolina has successfully found a way to increase transparency, balance competing industry stakeholder interests, and elevate the quality of care through recognition of pharmacy accreditation. All of this done in a way that saw broad bipartisan support.

As patients across the country demand more accountability for drug prices, this legislation is a measured approach that is foremost focused on protecting the interests of patients.

Senate Bill 359 passed the South Carolina General Assembly unanimously and was signed into law on May 16th. To read the text of the legislation click here.

image of Aaron Turner-Phifer

Aaron Turner-Phifer, Vice President, Government Relations and Policy.

Aaron Turner-Phifer, vice president of government relations and policy, has nearly a decade of experience advising and crafting public policy at the federal, state, and local levels. He has experience working on health care quality initiatives and public policy that impacts Medicare, Medicaid, and Health Insurance Marketplace enrollees. He is an expert political and policy analyst with a unique understanding of the intricacies associated with the development of health care policy. He achieved his Master of Health Administration degree from the George Washington University.

Views, thoughts and opinions expressed in my articles belong solely to me, and not necessarily to my employer.

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