Round Two (or is that Round Three) of the CVS vs. Walgreens knockdown has gotten folks attention. Walgreens came out swinging, both fighters felt each other out, and CVS counter punched with the announcement that, rather than wait for contract renewals to have Walgreens leave the Caremark network, they will take a proactive stance and end the network participation in 30 days. (http://bit.ly/bTUZfU)
For the original story, See *PBM Consulting – Networked?* at https://wbcbaltimore.com/blog/
This frontpage slugging back and forth between these two heavyweights has also captured the attention of Congress. The PBM industry has long avoided federal scrutiny and oversight. Their business practices and market conduct are juicy targets for a Congress and an Administration hungry for power and control. No crisis (real or contrived) is going to go unnoticed these days. Reps. Bruce Braley, D-Iowa, and Peter Welch, D-Vermont, have started the inquiry by sending a letter to three powerful House committee and subcommittee chairmen, calling for enhanced congressional oversight of the PBM industry and requesting a hearing on current industry practices!
Seems like Congress may just be waking up to what approximately 30 State Attorneys General have already started, that is, an attempt to bring some real transparency to the PBM world. Many pharmacy benefit plan sponsors have wondered why “traditional” PBM business practices have continued under the radar for so long. After all, Third-Party Administrators (“TPAs”) who are paid to process medical claims on behalf of health plan sponsors, would be shuttered and their officers indicted if they ran their businesses in a fashion similar to many PBMs!
Here’s a link for more details of Congressional interest: http://bit.ly/9iFGOl
WBC will continue to follow these developments to keep you informed regarding PBM news that may effect the operation of your plan. Visit us at www.wbcbaltimore.com