Legislative leaders must review state health insurance and drug benefit managers


June 10 – JACKSON – Leaders of the Capitol’s two insurance committees are hoping to find long-term solutions to the recent cash flow crisis at Mississippi’s insurance plan, which covers the state’s roughly 200,000 employees and retirees.

The House and Senate Insurance Committees are scheduled to hold a joint hearing July 19-20 on the state’s managed care insurance program and drug intermediaries known as pharmacy benefit managers.

“The elephant in the room is that our health insurance system is bleeding right now,” Senate Speaker Water Michel told the Daily Journal.

Michel, R-Madison, said state employees filed about $120 million in COVID-19-related claims last year, straining the system and forcing lawmakers to use one-time money to fill the hole.

To temporarily stop the bleeding, lawmakers agreed to supplement the recent loss with American Resource Plan Act dollars they received from the federal government.

“We just want to make sure we stay ahead of the curve with the plan,” Michel said.

The plan is overseen by the Department of Finance and Administration, but benefits are administered by Mississippi’s Blue Cross & Blue Shield, which works with another PBM to provide medication to enrollees.

Pharmacy benefit managers, or PBMs, are contractors often hired by health plans or employers to administer pharmacy benefits, negotiate drug prices with manufacturers, and reimburse pharmacists. Part of the job of PBMs is to negotiate rebates and other rebates from drug manufacturers. In exchange, they provide a pharmaceutical product with privileged placement.

But this surrender and negotiation process is often shrouded in secrecy and has led a litany of states like Ohio, Oklahoma, Georgia, New Mexico, Kansas and Arkansas to examine the practice.

The hearing comes after State Auditor Shad White’s office in March signed an agreement with a data analytics company to harvest a large amount of data from any PBM that has a contract with the ‘State.

When asked if investigations by the auditor’s office might have any relevance to upcoming hearings, Michel deferred to House Insurance chairman Hank Zuber, who he says is primarily responsible. the organization of the hearing.

Zuber, R-Ocean Springs, said hearings were scheduled to take place, but the agenda has not been finalized.

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