Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Key Takeaways

• The Reality of the "Pharmacy Spiral": Understand the impossible decisions pharmacy owners face when dealing with underwater claims and how it impacts patient care.
• Automating MAC Appeals: Learn how Pharmacy Marketplace's software identifies eligible claims, generates compliant invoices, and tracks the appeal timeline from start to finish.
• State-Level PBM Reform: Discover which states are leading the charge in enforcing underwater payment statutes and how organized data empowers agencies to audit non-compliant PBMs.
• Escalating Rejections: Find out exactly what to do when a PBM rejects your appeal and how to involve your state's Department of Insurance or Attorney General.
• Advocacy in Action: Hear the latest updates on the Tennessee PBM divestiture bill and learn why independent pharmacies must actively participate to drive legislative change.

Resources

• Pharmacy Marketplace: Learn more about the MAC appeal tool and watch the demo video at pharmacymarketplace.com
• Contact Kris Rhea: Reach out directly at Kris@pharmacymarketplace.com
• Pharmacists United for Truth and Transparency (PUTT): Join the fight for PBM reform and access more advocacy resources at truthrx.org

Special Guests: Nikki Bryant, PharmD - Georgia independent pharmacy owner & Pharmacy Advocate; Rosemary C Smith, RPh - co-founder Kentucky Independent Pharmacists Alliance

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Join PUTTcast host Lauren Young and PUTT President Deborah Keaveny, with special guests Senator David Koehler, Representative Natalie Manley, IPhA Executive Director Garth Reynolds, and IPhA President David Bagot, as they explore the impacts of this victory and what it signals in the fight for healthcare justice.

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Special Guest: FairRx founder & Mississippi pharmacy owner, Fair Jones, PharmD

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

At its core, PBM reform is not just a critical pharmacy issue - it’s a patient care issue. Join us for this insightful episode as we explore how independent pharmacies can use psychology, AI, and community-building strategies to craft testimony, fight misleading PBM narratives, and create a united voice for reform. 

Special Guest: Ken Patel, RPh, co-founder Arizona Independent Pharmacy Coalition

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Special Guests:

• AR State Representative Jeremiah Moore
• AR State Senator Kim Hammer
• AR State Representative Brandon Achor
• Arkansas Pharmacists Association CEO John Vinson

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

In this episode, we sit down with Congresswoman Diana Harshbarger to dissect the pressing issues surrounding PBM practices and discuss why now is the time to act. From federal legislation already in the works to the decisive importance of the first 100 days of 2025, Congresswoman Harshbarger walks us through her goals for actionable, enforceable PBM reform.

Special Guest: Congresswoman Diana Harshbarger (R-TN)

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

In this conclusion to our live Summit day recording, we dive deeper into the critical issues facing the pharmacy industry today. The discussion picks back up on the front lines of PBM reform, exploring reform’s real-world impact on patients and independent pharmacies, then shifts to a powerful and often-debated topic: the case for unionization in pharmacy. But it's not all serious business. Maurice Shaw (The Dr of Comedy) and Shane Jerominsky (The Accidental Pharmacist) bring their unique perspectives as pharmacists and comedians to point out the comedic moments found in everyday pharmacy life - reminding us that laughter can be a powerful tool for coping with the immense pressures of the pharmacy profession.

Special Guests: Maurice Shaw, PharmD, Shane Jerominsky, RPh, & Greg Reybold, APCI VP of Healthcare Policy & General Counsel

Music by cat_herding_diva & JuliusH | Mixing by Andre Barden | Production & Editing by Shannon Wightman-Girard

Tired of legalese and political jargon surrounding federal prescription drug reform? This episode dives deep into President Trump’s recent healthcare reform Executive Order and what it really means for patients and their pharmacies. We’ll untangle topics like:

• The truth behind IRA drug price negotiations and how they could impact pharmacies and ultimately, patient access.  
• Why Medicare and Long Term Care pricing continues to be a battleground. 
• How prescription drug rebates under current Safe Harbor laws create more problems than solutions.  
• The shocking facts behind drug pricing disparities and their real-world consequences.  
• The ongoing battle for PBM reform - and what could lie ahead.

We’re joined by Mark Boesen, J.D., PharmD, of Boesen & Snow Law, who brings his expertise in pharmaceutical law, policy, and advocacy to help us decode the political language. Together, we discuss who could benefit and who could be harmed - because when it comes down to it, prescription drug reform and PBM reform are 2 sides of the same coin.

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Joined by special guests Mark Boesen of Boesen & Snow Law, Matt Seiler of NCPA, and Miguel Rodriguez of American Pharmacies, this episode takes a deep dive into the massive gap between existing PBM reform laws and on-the-ground compliance. Our panel breaks down the recent Federal Trade Commission (FTC) proposed settlement with Express Scripts, exposing what it means for independent pharmacies, and explores the recent alarming state audit findings that highlight a systemic failure by PBMs to follow state laws.

Whether you’re a pharmacy owner, a legislator, or a healthcare advocate, this episode will shed light on why robust enforcement at both the state and federal levels is not just beneficial, but absolutely vital for the survival and longevity of the independent pharmacy industry.

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Key Takeaways

1. The Enforcement Gap: Having laws on the books means little without the resources and regulatory teeth to hold PBMs accountable for non-compliance.
2. Government Role in PBM Oversight: The Express Scripts proposed settlement signals a shift in federal attention, with the goal of creating new precedents for how PBM practices are handled.
3. State Audits Reveal Systemic Issues: Recent state-level audits have uncovered glaring patterns of PBMs ignoring statutory mandates, emphasizing the need for stricter state DOI and AG interventions.
4. Future Enforcement Guidelines: Future PBM reforms must include built-in enforcement mechanisms, mandatory auditing, and severe penalties for violations.
5. Benefits to the Industry: Proper enforcement ensures fair reimbursement rates, protects patient choice, and levels the playing field for independent pharmacies.

Guest Information

Mark Boesen, PharmD, JD

Founding Partner, Boesen & Snow Law

Mark brings a unique dual perspective as both a pharmacist and a legal expert. He specializes in pharmacy law, regulatory compliance, and government affairs, fighting tirelessly for the rights of independent pharmacies.

Matt Seiler, Esq.

VP & General Counsel, National Community Pharmacists Association (NCPA)

Matt leads the legal strategy for NCPA, advocating for the nation's independent community pharmacies. He is at the forefront of the battle against anti-competitive PBM practices at the federal level.

Miguel Rodriguez, Esq.

EVP & General Counsel, American Pharmacies

Miguel is a leading voice in PBM litigation and legislative reform. Through American Pharmacies, he drives aggressive legal and advocacy strategies to ensure PBM transparency and accountability.

Join the Fight for PBM Reform!

If you found this episode valuable, please share it with your colleagues, state representatives, and fellow pharmacy advocates. Make sure to subscribe to PUTTcast on your favorite podcast platform so you never miss an update on the fight for fair pharmacy practices. For more resources and to join our mission, visit our website at TruthRx.org

We're breaking down the biggest moments from the 2025 PUTT Virtual Summit, and diving deep into the ever-changing world of PBM reform. This powerhouse discussion features an incredible lineup of guests who share their unique perspectives on the latest legislative battles, grassroots advocacy, and what independent pharmacy owners are facing on the front lines.

Special Guest: Greg Reybold, VP of Healthcare Policy & General Counsel, APCI

Music by cat_herding_diva & JuliusH | Mixing by Andre Barden | Production & Editing by Shannon Wightman-Girard

If you find this episode valuable, please share it with your network and consider reaching out to your federal legislators to express your support for H.R. 9096: The Pharmacists Fight Back Act.

Special Guests: Greg Reybold, APCI VP of Healthcare Policy & Monique Whitney, PUTT Executive Director

Useful Links:

Find Your Legislator: Find and contact elected officials | USAGov

H.R. 9096 The Pharmacists Fight Back Act: https://www.congress.gov/bill/118th-congress/house-bill/9096

Federal Employee Health Benefits Plan Drug Pricing, Variability, Specialty Drug Markups, & Steering Uncovered (APCI white paper): https://www.apcinet.com/Portals/0/leg-affairs/insights/apci-insights-002.pdf

Music by Oleg Fedak (https://pixabay.com/users/soulprodmusic-30064790)

Production & Editing by Shannon Wightman-Girard

This episode is a wake-up call for employers and policymakers alike. 

Join PUTTcast host Lauren Young, co-host Chris Hobart, PharmD, and special guest Chris Deacon, JD, as they bring unparalleled insights into how regulatory enforcement, employer education, and data transparency are key battlegrounds in the critical fight for accountability.

Episode Guest: Chris Deacon, JD, owner, VerSan Consulting, former NJ Deputy Attorney General, and past Director, NJ state health plan

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

In our first episode, host Lauren Young dives into the intricacies of House Bill 9096, also known as the Pharmacists Fight Back Act. Joining her are distinguished guests—Congressman Jake Auchincloss (D-MA), Greg Reybold, Vice President of Healthcare Policy & General Counsel at the American Pharmacy Cooperative, Inc. (APCI), and Monique Whitney, PUTT Executive Director. Together, they unravel the essentials of this pivotal PBM reform bill and its implications on drug prices, patient access, the viability of independent pharmacies, and enforcement measures.

Guests:

• Congressman Jake Auchincloss (D-MA): A prominent advocate for healthcare reform and sponsor of H.R. 9096 with Congresswoman Diana Harshbarger (R-TN), Congressman Auchincloss brings a wealth of knowledge and legislative experience to the discussion.
• Greg Reybold: Greg is the VP of Healthcare Policy & General Counsel at APCI (American Pharmacy Cooperative, Inc.). He brings extensive knowledge on healthcare policy and the intricacies of PBM regulations.
• Monique Whitney: Monique serves as the Executive Director of the nonprofit Pharmacists United for Truth & Transparency. As a vocal advocate for PBM reform, she offers a unique perspective on how HR 9096 will affect pharmacies and patients alike

• Federal Employee Health Benefits Plan: Drug Pricing, Variability, Specialty Drug Markups, & Steering Uncovered (APCI white paper)
• H.R. 9096 The Pharmacists Fight Back Act

Music by Oleg Fedak (https://pixabay.com/users/soulprodmusic-30064790)

Production & Editing by Shannon Wightman-Girard

Music by cat_herding_diva | Production & Editing by Shannon Wightman-Girard

Key Topics:

1. Pass-Through vs. Traditional PBMs: Breaking down the fundamental differences and why the distinction matters for transparency.
2. How Traditional PBMs Game the System: A look at the tactics legacy PBMs use during the evaluation process to confuse employers and hide profit margins.
3. The Benefits for Employers: Why switching to a pass-through model can lead to significant savings and clearer data for plan sponsors.
4. The Cost-Plus Pharmacy Model: Explaining how this model works and its direct benefits for patient affordability and employer bottom lines.
5. The Role of Independent Pharmacies: How integrating independent pharmacies into benefit plans can simultaneously decrease employer spend and increase pharmacy reimbursement.
6. Market-Driven Reform: Why legislative action isn't enough—the market must actively demand better solutions to ensure PBM reform is effective.

Resources & Links

1. SmithRx: Visit Website
2. Pharmacists United for Truth & Transparency (PUTT): TruthRx.org
3. Support the Show: Become a PUTTcast Sponsor