HARRISBURG – Sen. Judy Ward (R-30) and Sen. Lisa Boscola (D-18) introduced legislation, Senate Bill 1186, that would protect patient access to pharmacies by establishing a single pharmacy benefit administrator (PBA) model for Pennsylvania’s state-funded health care programs.
Under this system, the state Department of Human Services would competitively contract with one pharmacy benefit manager (PBM) to administer all prescription drug benefit programs, which would eliminate the patchwork of PBMs, provide fair and transparent reimbursement to cover pharmacies’ costs and protect patient access to health care. The legislation would also prohibit this single PBA from engaging in predatory practices such as patient steering, spread pricing and specialty drug designation manipulation.
“Pharmacies continue to close at an alarming rate, leaving countless Pennsylvanians without access to necessary medication and services,” said Ward. “The single PBA model has shown promise in other states, and it will create a new environment where pharmacies can continue to provide the lifesaving health care so many of our constituents depend on.”
“Community pharmacies are the front door to our health care system, and too many of them are hanging on by a thread,” said Boscola. “This legislation gives us a transparent, accountable model that ensures pharmacies are paid fairly, patients can get their medications close to home, and taxpayers actually see savings instead of waste.”
The Senate Community Pharmacy Caucus held a recent hearing to highlight the problems facing pharmacies and the need for reforms, including the benefits seen in other states when adopting a single PBA model. Ohio adopted this model in 2019, and in just two years, it saved the state $333 million in administrative costs and allowed $700 million in dispensing fees to go directly to pharmacies. A 2025 report found that Ohio’s Medicaid program is now the most stable and reliable payer for its pharmacists. Kentucky followed suit, saving $283 million in the first year. The Virginia, Minnesota and Nevada legislatures have passed similar legislation.
Ward contact: Nathan Akers; 717-787-2421
Boscola contact: Joseph Kelly; 610-868-8667