Capitol Notebook: Pharmacy benefits manager bill ready for Iowa Senate debate

DES MOINES — Legislation created with the goal of limiting prescription drug costs and helping pharmacies — especially in rural, small towns — avoid going out of business by addressing pharmacy benefits managers advanced out of an Iowa Senate committee on Wednesday.

Pharmacy benefit managers are companies that function as intermediaries between insurance providers and drug manufacturers.

Legislation introduced in both chambers of the Iowa Legislature would require all prescription drug contracts to use a pass-through pricing model, by which the amount paid by the PBM to the pharmacy is passed through to the plan sponsors — employers, insurers, government agencies, or managed care organizations — and the PBM is compensated through administrative fees, according to the Pharmaceutical Care Management Association, which represents PBMs.

The bill also requires PBMs to provide an appeals process for pharmacies to challenge reimbursement rates for specific prescriptions, and would allow pharmacies to decline to dispense a prescription to a person if the pharmacy would be reimbursed less for the prescription than the cost to the pharmacy.

Also under the proposed legislation, PBMs would be prohibited from:

The Senate’s version of the bill, Senate Study Bill 1084, was approved Wednesday by the Senate Health and Human Services Committee. The bill passed on a voice vote, with no Senators asking to be registered in opposition. The bill is now eligible for debate by the full Senate.

Opponents of the bill, including PBM companies, have warned that it could lead to higher costs for consumers.

Sen. Mike Klimesh, R-Spillville, who is managing the bill and chairs the Senate Health and Human Services Committee, said the proposal uses concepts approved in other states that he said have been successful.

“Nothing in this bill is new,” Klimesh said during the committee meeting. “There is data out there that shows this bill does not precipitate the sky falling.”

Klimesh said with pharmacies closing in Iowa, lawmakers feel compelled to act.

Last year, 29 pharmacies closed in Iowa, according to the Iowa Pharmacy Association.

“It is so important that we get ahead of this,” Klimesh said. “I fear if we wait a year or two, we’ll get to the point of no coming back.”

Senate advances hunting constitutional amendment

A bipartisan panel of three Senators recommended on Wednesday a resolution to codify a constitutional right to hunt, fish and trap wildlife in Iowa.

A similar resolution in the House — which received committee approval last week — has been opposed by Democrats.

There was no similar immediate opposition in the Senate, where the lone Democrat of a Natural Resources and Environment subcommittee — Sen. Sarah Trone Garriott, of Waukee — agreed to move the resolution forward.

However, she said Senate Study Bill 1132 needs to explicitly say that state regulators would be charged with creating rules for the activities, as the Iowa Department of Natural Resources does now.

That language is contained in the House version but is absent in the Senate resolution. Lobbyists for hunting groups agreed that it is needed.

“We don’t think that the General Assembly really wants (the responsibility for) setting bag limits, for example, and hunting seasons,” said Marc Beltrame, of Ducks Unlimited. “Those are typically activities that are promulgated through rules.”

Trone Garriott and Republican Sens. Annette Sweeney, of Alden, and Dan Zumbach, of Ryan, agreed to move the resolution forward and pursue the change.

Such resolutions require passage in the House and Senate in two successive General Assemblies before voters decide whether to amend the Iowa Constitution.

Humane World for Animals, formerly the Humane Society of the United States, opposes the amendment because it protects “traditional methods” of hunting and trapping.

"We believe that that phrasing is unnecessarily vague and unfortunately would include methods that are no longer acceptable to the American public, nor the Iowa public," said Preston Moore, who spoke for the group. "There's only one state currently that allows bear leg hold traps to be used because the American public finds it abhorrent."

Iowa no longer has a resident bear population, but black bears occasionally wander in from neighboring states.

Senate committee approves pesticide tort bill, sports betting regulations

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Republicans on the Senate Judiciary Committee gave their approval Wednesday to legislation that would protect agricultural chemical companies from lawsuits over warning labeling on their products.

The committee also, with more bipartisan support, gave its blessing to legislation that would clarify in state law that sharing sports gambling accounts with other bettors is illegal, and that state law enforcement officials have the authority to investigate those alleged crimes.

Senate Study Bill 1051 would shield agricultural chemical companies like Bayer, which produces the glyphosate-based herbicide Roundup, from lawsuits claiming the company failed to warn consumers of health risks if the product label complies with federal labeling requirements.

Supporters say the bill is needed to protect companies that adhere to federal labeling regulations from frivolous lawsuits. Bayer has faced around 167,000 lawsuits from individuals claiming the company failed to warn them about the health risks of their products.

Critics of the bill say it would make it more difficult for Iowans who believe they are injured by agricultural chemicals to seek legal relief.

The bill passed out of the committee on an 11-7 vote, mostly with Republicans supporting and Democrats opposing. The bill is now eligible for debate by the full Senate, which approved a similar bill last year on a similar party-line vote. The House did not take up the bill.

The committee also approved Senate Study Bill 1097, which would add prohibitions on account sharing and proxy betting to the crime of illegal gaming in state law. Currently, the prohibitions appear only in the state’s administrative rules.

The bill passed on a 17-1 vote and is now eligible for debate by the full Senate.

Gazette-Lee Des Moines Bureau

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