Pharmacy Benefit Managers- Drug Price Transparency (DPT) submission deadline postponed

Washington State Health Care Authority sent this bulletin at 02/19/2021 03:00 PM PST

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Pharmacy Benefit Managers- Drug Price Transparency (DPT) submission deadline postponed

You are receiving this notification because the Health Care Authority (HCA) originally informed you that Drug Price Transparency (DPT) data submissions for Pharmacy Benefit Managers (PBMs) were due March 1, 2021.

At this time, we are postponing the due date.

Why is the submission date being delayed?

HCA received your feedback on the data submission guide and determined that some redesign is necessary in order for the reporting process to work smoothly and accurately. We are prioritizing this and will extend the submission deadline rather than rushing to meet a date and sacrificing user experience.

We are making four main changes during this process:

The PBM health plan report will change to a PBM formulary report, and PBMs will be able to report multiple formularies in one file instead of needing to submit separate files.
The PBM appeals report will be modified to add a field for PBMs with no appeals to report. PBMs with no appeals will still be required to submit this report by using this new field.
The PBM drug benefit plan report will be updated to allow more detailed reporting of benefit options offered by PBMs.
The data submission guide, templates, and due dates will be updated accordingly.

What do I need to do?

At this time, there is nothing required of you other than to sit tight and wait for HCA to let you know we have completed the changes and updated the reporting resources. If you have completed the reports that are not mentioned above, you may still submit them.

We will be following up in late February or early March to inform you that the changes are in place, and of a new reporting submission due date. The due date will be no sooner than 30 days after the forthcoming notification.

If you have not already done so, you need to register as a data reporting entity

Please register, or have the appropriate representative of your organization register, your entity as a data reporting entity for the DPT program. If you are not the correct contact in your organization, please forward this to the appropriate parties so they may register.
To register, please download, complete, and return the reporting entity registration form.
- Please only submit one registration for each subsidiary or affiliate of your organization that meets the definition of a Pharmacy Benefit Manager (PBM).
- Once complete, email the form back to HCA.

What if I am exempt from the reporting requirement?

All PBMs are required to submit data. If you believe you are not required to report, please email HCA with a detailed explanation.

Still have questions?

If you have questions, please contact program staff at drugtransparency@hca.wa.gov.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.