Following veto of patient steering bill, California pharmacists express disappointment


Soraya Marashi


Among the numerous bills vetoed by Gov. Gavin Newsom in his final decisions on 2021 legislation signings on Saturday, Senate Bill 524, authored by Sen. Nancy Skinner, was one of them. The “Choose Your Own Pharmacist” bill would have helped ensure that patients can use the pharmacy they prefer by prohibiting health care plans and their agents from limiting what pharmacies can be used.

In his veto statement, Gov. Newsom expressed his reluctance to sign the bill due to a lack of clarity in specific language used, stating:

“While offering consumers a choice in pharmacies within their health plan or insurer networks is a worthwhile goal, the bill lacks clarity in key areas which may render it subject to misinterpretation or a lack of enforceability. It is unclear what business relationships between health plans, insurers, and their agents are intended to be affected because the bill does not define ‘agent’ or ‘corporate affiliate.’ Furthermore, it is unclear what it means to ‘limit an enrollee’s (or insured’s) access’ to certain pharmacy providers.

It is necessary to define these terms and concepts so appropriate oversight and enforcement may occur, particularly in light of the complexity of the contracting arrangements and benefit designs at issue. Finally, it is important to ensure that efforts to address these concerns do not have the unintended consequence of interfering with the ability of health plans and insurers to coordinate care and contai pharmaceutical costs for California’s consumers.”

Susan Bonilla, CEO of the California Pharmacists Association (CPhA), on the other hand, expressed the organization’s disappointment in Newsom’s decision in a statement to State of Reform:

“California had the opportunity to demonstrate that we are truly a state that believes in protecting the rights of patients over the profit-driven motives of multi-billion corporations … [Patient steering] is an inherent conflict of interest. Nowhere in the practice of medicine would these self-dealings be allowed.

The bill received bi-partisan support and the author is well respected for her willingness to fight for Californians against corporate greed.”

Bonilla went on to say that the bill’s only significant opposition was fromentities who benefit financially from these businesses’ practices. She said CPhA doesn’t see the situation as a complete failure.

“The amount of bi-partisan support this bill received against a tremendous amount of opposition, is significant. The role of pharmacists has changed significantly in recent years. Pharmacists have been granted additional authorities, which illustrates the faith policymakers have in them as members of the healthcare team.”

She detailed some of the unique responsibilities of pharmacists, adding that, despite SB 524’s failure, “the future of pharmacy is bright.”

“Many of our members are providing direct care in their communities, working through collaborative practice agreements with physicians to provide comprehensive care, specializing in HIV, Hepatitis, Cancer, etc. Pharmacists utilize their authority to independently initiate and provide self-administered birth control and PEP/PrEP and provide a valuable service within the communities in most need. Community pharmacists also meet patients where they lie, routinely going to homeless encampments to ensure their patients receive their medications. The future of pharmacy is bright which will benefit the communities in which they practice.”

The California Chamber of Commerce voiced several criticisms of the bill and officially stated its opposition to the bill in its published legislative priorities.

“… [SB 524] would have increased prescription drug costs for consumers by preventing certain network designs between employers, health plans, insurers, pharmacy benefit managers, and pharmacies.”

In the original press release announcing the bill’s unanimous approval by the Senate, Skinner stated:

“It’s not unusual for a family to have a longstanding relationship with a trusted pharmacy. As long as that pharmacy is in network, there’s no reason for an insurer to prevent a patient from using it. SB 524 will prohibit most insurers from requiring one particular pharmacy when there is no clinical reason to do so, thereby ensuring patient choice.”

Skinner was unavailable to provide comment for this story.