In the most recent episode of Managed Healthcare Executive’s “DC Roundtable,” podcast, Patrick Cooney discussed the prospects of pharmacy benefit manager (PBM) legislation in the Congress.
Cooney said Democrats and Republicans are “pretty united on wanting to see some changes and transparency” in the PBM, adding that Congress is also interested in transparency for health insurers and hospitals. “I don’t think they’re necessarily just ganging up on the PBMs.”
Cooney is president of The Federal Group, a Washington, D.C., lobbying and advocacy firm that has a number of healthcare interest groups as clients, including the American College of Nurse-Midwives, the Medical Device Manufacturers Association, the Emergency Care Research Institute and the American Physical Therapy Association.
Cooney is also a consultant to the Pharmacy Benefit Management Institute (PBMI), which is owned by MJH Life Sciences, the parent company that owns Managed Healthcare Executive.
Cooney noted during the podcast that the Congressional Budget Office “scoring” of the budget impact of some of the PBM legislation shows the effect to “just a couple of billion dollars over a 10-year period. “That’s not big money in Washington terms.”
Some lawmakers wanted to include PBM provisions in the large spending bill that Congress passed last month and was signed by President Biden.Cooney said Congress will be focusing on 2025 fiscal year during the summer months, then the attention will shift to the presidential and other elections on Nov. 5, which will be followed by a lame-duck session.
“There's not going to be a lot more bites of the apple on [the PBM] legislation,” observed Cooney, but he added that “they'd like to get this done.”
“There's probably going to be another opportunity in the summer. And then the last opportunity would be in a lame-duck session after the elections. But I got to believe that legislators, both Democrats and Republicans want to go home with some victories,” said Cooney.
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