At the Georgia Capitol, a quiet but fierce showdown is brewing between independent pharmacists and the pharmacy middlemen they say are bleeding them dry. A new proposal aims to clamp down on pharmacy benefit managers, or PBMs, and backers insist it could be the difference between survival and shuttered storefronts for local drugstores.
What The Bill Would Do
House Bill 810 would lock in a formula for how pharmacies get paid. Under the bill, PBMs would have to reimburse pharmacies at no less than the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee of $10.64, with that fee adjusted annually based on medical inflation, according to the bill text. LegiScan shows the measure would also bar PBMs from cutting special lower deals with nonaffiliated pharmacies and spells out fallback pricing rules if NADAC figures are not available.
Pharmacists Pressed Lawmakers
Independent pharmacists lined up at the Capitol to explain why those numbers are not just policy jargon, but make-or-break math. Little Five Points pharmacy owner Ira Katz bluntly labeled current PBM pricing “fraud” and told legislators he often loses money just by filling prescriptions. In southwest Georgia, owner Nikki Bryant testified that she now bakes biscuits and cakes before dawn to subsidize her two pharmacies and keep them open. Atlanta News First reported that sponsor Rep. Rick Jasperse cast the bill as a way to protect community anchors, saying he has watched family-run pharmacies disappear from his own district.
Where The Measure Stands At The Capitol
The proposal has cleared its first big hurdle. It moved out of committee with a favorable report, setting it up for a vote by the full House. LegiScan reflects that committee action, and Atlanta News First notes that the bill has to pass the House by Friday’s crossover deadline if it is going to stay alive this session.
Opponents Warn Of Higher Costs
PBMs and health-plan trade groups are not exactly cheering the proposal on. They argue that richer payments for pharmacies will not come from thin air. WRDW reported that Jesse Weathington of the Georgia Association of Health Plans warned those higher pharmacy reimbursements would likely end up paid by the insured or by employers footing the bill for coverage.
Why Local Pharmacies Say It Matters
Independent owners counter that the system is already stacked against them. Advocates point to a wave of closures and what they describe as massive hidden markups. WRDW cites the Georgia Pharmacy Association as saying more than 200 pharmacies have closed in the state since 2015 and that PBM practices have cost Georgians roughly $400 million above national average drug acquisition costs in recent years. Public-health researchers who testified urged lawmakers to factor in access for rural and low-income communities and argued that PBMs could absorb at least some of the proposed changes without simply shifting costs onto patients.
Legal And Practical Implications
Backers say HB 810 would solidify protections that started in earlier legislation while carving out specific treatment for some state plans. According to a summary from the trade group and the bill language, the measure would apply to Medicaid care-management programs and require state agencies to submit any needed plan amendments to comply. Georgia Pharmacy Association and the bill text outline how the new reimbursement formula and the professional dispensing fee would actually be rolled out if the measure becomes law.
What To Watch Next
With crossover day looming, both sides are ramping up pressure in the hallways of the Capitol and in conversations with employers that buy health coverage. Lawmakers can still tweak HB 810 on the House floor, tightening or trimming its scope, before sending any version that survives across the hall to the Senate.
