SAVANNAH, Ga. (WTOC) - It is likely that within the last year you have received a letter or a phone call from your insurance company stating that you can save money by using mail order prescriptions or that you must use a specific pharmacy suggested by your insurance company. What you may not know is that Georgia has just passed a law that may allow you to continue using whatever pharmacy you would like.
In the early months of 2020, the state of Georgia passed House Bill 323, also known as the Pharmacy Anti-Steering and Transparency Act. The laws prohibit PBM (or insurer-owned pharmacies) from profiting off prescriptions "steered" from their PBM and insurance affiliates. They also restrict PBM and insurer patient steering, strengthen anti-mandatory mail order, add additional audit protections, and restrict mining of patient data. The Pharmacy Transparency and Anti Steering Act attempts to meet three goals; increase transparency, allow patients to choose their pharmacy, and make sure patients receive quality care regarding pharmacy services.
So, how do you handle the situation if your insurance carrier tells you must use mail order pharmacy? You may be able to simply opt out by calling them. Telling patients they must use mail order takes away the patients right to healthcare professionals help them manage their medications. Approach the subject with your insurer by calling the phone number on the back of your insurance card. The good news is if you are persistent with your insurance company, they might comply and allow you to continue to use your local pharmacy.