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Departing Puerto Rico gov enacts law to oversee PBMs

By on July 30, 2019

To establish protocol for those in government health plan network

SAN JUAN — Outgoing Gov. Ricardo Rosselló signed Tuesday Senate Bill 218, which seeks to establish oversight for pharmacy benefit managers (PBMs).

The new measure allows the Health Insurance Administration (ASES by its Spanish acronym) to regulate and establish protocols for PBMs it has contracted as part of its network to offer services through the Puerto Rico government’s health plan.

The measure, now known as the Pharmacy Benefits and Services Managers Regulatory Law, creates the Office of the Regulatory Commissioner for Pharmacy Benefits and Services Managers, which will be attached to the Department of Health.

This legislation will also control one of the components within the health services chain that, so far, has no regulation, according to a release issued by the governor’s office, La Fortaleza.

“My commitment to health remains firm. We need to protect patients and the provision of health services, thus effectively regulating PBMs” is necessary, said Rosselló, who is expected to officially resign Friday.

The governor added that “unjustified increases to medications are unacceptable. We need to regulate each link in the chain of production and dispensing of drugs effectively to ensure we obtain the most accessible prices for our citizens. In that sense, this measure is a step forward.”

The office created under this law will be responsible for requiring the licensing of any PBM that operates in Puerto Rico, addressing reimbursement claims and ensuring that payments to pharmacies are complied with.

In addition, the office will be tasked with prohibiting PBMs from unilaterally altering patient prescriptions; ensuring that the drug approval process does not exceed 72 hours; and with issuing fines for any violations.

“This initiative joins other efforts of the Rosselló Nevares Administration, aimed at serving the remaining participants in the chain with the aim of promoting transparency and solving the problem of the high cost of medicines,” the release concludes.