Based in Coeur d’Alene, Idaho Medicine Man Prairie pharmacy owners, Korey Kreider and Jordan Redman have persistently advocated on behalf of independent pharmacy, championing legislation that Idaho signed into law requiring fair audits and fair reimbursement practices for pharmacies.

Challenge

Several pharmacy reimbursement and audit bills were stalled with legislators in the state of Idaho. There was a general lack of understanding of pharmacy reimbursement and audit practices, and it wasn’t a priority for lawmakers. 

Solution

Korey and Jordan’s business coach shared advocacy efforts and progress that was being made  in other states and this motivated them to research what could be done in their own pharmacy’s home state of Idaho. After a few visits to the capital, the owners realized that the congressmen weren’t familiar with audit and reimbursement practices by PBMs. They spent time explaining the details and addressing questions, closing the knowledge gap with congressmen, and bringing these issues to the forefront for more timely consideration. 

Outcome

With Korey and Jordan’s persistence, a Fair Pharmacy Audits bill was passed which put very clear boundaries in place for PBMs, including limiting the number of claims per quarter, limiting claims to less than a year old, and eliminating pharmacy repayment for minor non-clinical errors that resulted in no patient harm. Additionally, a pharmacy reimbursement bill was passed, which prevents PBMs from reimbursing pharmacies below cost and is enforced by the Department of Insurance who issues steep fines to PBMs for violations.