CMS NEEDS TO ENSURE TRANSPARENCY IN ITS ROBUST BUSINESS RELATIONSHIP WITH THE LARGE PHARMACY BENEFIT MANAGERS (PBMS)

Three large PBMs manage prescription drug benefits for more than 180 million Americans. PBMs have clients on two sides - pharmacy clients and health plans/payors (Medicare, DoD TRICARE and FEHBP). They also own their own mail order and/or retail pharmacies and that puts them in direct competition with their small pharmacy clients. This leverage incentivizes them not to reimburse their small pharmacy clients in a fair and timely manner - this is not just and Congress needs to support CMS in their efforts to scrutinize these unfair practices.