FILE - PA pharmacy Lancaster 12-11-2018

A pharmacist helps out a customer Dec. 11, 2018, at Royer Pharmacy in Lancaster, Pennsylvania.

(The Center Square) – A bill under the microscope in Harrisburg has been touted by a group of lawmakers as a mechanism for promoting the state’s independent pharmacies. But disparate organizations are taking aim at the legislation, citing increased taxpayer costs and other potential consequences.

Early this summer, before the legislative recess, members of the Senate Health and Human Services Committee voted unanimously in favor of House Bill 941, which is part of a package of four bills addressing pharmacy benefit managers and prescription costs across the state.

HB 941 and related proposals have been circling through state government for much of the past year. House lawmakers held a hearing and deliberated on the bills late last year.

Several changes have since been incorporated into HB 941. A provision known as Amendment 06484 for example, would require Medicaid-based managed care organizations, or MCOs, to pay a $10 dispensing fee to pharmacists across the state. Other changes address reimbursement protocol and other technical matters.

While much of the lawmakers’ discussion has focused on independent pharmacies, the dispensing fee also would apply to pharmacists working at larger, national-based retail chains.

Shortly before the summer recess, the state Senate Health and Human Services Committee in June voted in favor of the amendment. The bill is slated to advance to the full Senate in September.

At the committee meeting, held June 29, state Sen. Michele Brooks, R-Greenville, described the amendment as “technical changes to the disclosure of information.” The addition of a dispensing fee, she said in her description, was “reasonable.”

But in the months since the committee made its bipartisan vote in support of the amendment to HB 941, disparate advocacy groups have gone on the offensive, attempting to poke holes into the amendment proposal.

The Pharmaceutical Care Management Association, which spoke out against the package of bills late last year, has implored Brooks and other lawmakers to consider the full impact of the amendment.

“PCMA opposed HB 941 because it increases pharmacy profits at the expense of consumers and taxpayers,” Lauren Rowley, senior vice president of state affairs with the PCMA, wrote in a letter to the Senate Health and Human Services Committee.

Rowley continued, “It unnecessarily codifies language that could be resolved in the contracting process and raises more questions than answers in relation to administering the pharmacy benefit.”

The advocacy group Americans for Tax Reform also has weighed in on the proposed changes, with concerns. Grover Norquist, president of the organization, said state health care costs could increase $200 million this year.

“If implemented, this bill would increase regulations and further curtail free market forces in health care, while also failing to preserve the right of private contract,” Norquist wrote in a letter to Pennsylvania lawmakers.

Of the proposed changes, Norquist said HB 941 and its subsequent amendment “would expand the government’s already excessive role in order to benefit small community pharmacists at the expense of taxpayers.”

During deliberations on the amendment two months ago, members of the Senate Health and Human Services Committee acknowledged the planned changes would weigh on Pennsylvania’s balance sheet, though they defended the proposal.

“While I am concerned about the cost, like everyone else, we can’t always balance the budget and save money by crushing the little guy,” state Sen. Sharif Street, D-Philadelphia, said. “I think the reality is if there really is this much additional cost, that really shows how much we were underfunding, and just crushing, small businesses.”

State Sen. Arthur Haywood III, D-Abington, said he also was concerned about the impact to the state budget, but defended the plan in motion. He acknowledged “the speed in which we got to this amendment” while sharing why he was voting in favor of it.

“Where will the independent pharmacists be, unless we take some action?” Haywood said.