PBM Reform Podcast
Pharmacy benefit managers were created as middlemen to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negotiate costs between pharmacies and health plans. Over time, PBMs have been allowed to operate virtually unchecked. A lack of transparency in PBM practices has led several states to implement licensure/registration, fair pharmacy audit, or generic drug pricing legislation to try to level the playing field for pharmacies and patients. This Podcast is focusing on discussions & interviews about PBM Reform & those and Business of Pharmacy professionals leading this much needed reform.
Episodes
Transparency, Auditing, and the PBM Shell Game | PBM Reform Podcast
In this episode of the PBM Reform Podcast, host Greg Reybold, Vice President and General Counsel at APCI, welcomes Josh Golden, Senior Vice President of Strategy at Judi Health and a nationally recognized voice in Pharmacy Benefit Manager reform.
With more than 20 years of healthcare consulting experience, Golden brings deep expertise in vendor procurement, contract negotiation, plan design, and b
Tennessee PBM Reform Win | APCI PBM Reform
Tennessee lawmakers have passed a major pharmacy reform bill aimed at pharmacy benefit managers, or PBMs, by barring companies from owning both a PBM and a pharmacy. The legislation is widely seen as targeting CVS Health, which owns Caremark and operates pharmacies across the state.
Supporters say the bill is designed to curb vertical integration, restore fair competition, and protect independent
PBM Reform Updates, Next steps, from CPhA | PBM Reform Podcast
In this episode, listeners get to know the leadership of the California Pharmacists Association (CPhA), exploring their professional journeys, personal backgrounds, and the experiences that shaped their commitment to advancing the pharmacy profession.
Susan Bonilla, CEO of the California Pharmacists Association, joins Dr. Sean Kim, PharmD, Vice President of Practice & Professional Development
Bagging Better Benefits: The Grocery PBM Disruptor | PBM Reform
How Kroger does PBM and the future of community pharmacy is clinical encounters.
Pharmacists Fight Back! Live on Capitol Hill | PBM Reform; Presented by APCI
American Pharmacy Cooperative, Inc. (APCI) called on Congress on Thursday, December 11, 2025 to pass the reintroduced Pharmacists Fight Back Act, two coordinated pieces of federal legislation designed to reform pharmacy benefit manager (PBM) practices.
The Pharmacy Podcast Network provides exclusive coverage of the event held on Capitol Hill.
U.S. Congressman Jake Auchincloss | PBM Reform
In this episode, Greg Reybold speaks with Jake Auchincloss, U.S. Congressman of Massachusetts 4th District.
Don't Get Paid Below Your Cost Anymore! | PBM Reform
This week on the PBM Reform Podcast, Breck L. Rice takes listeners inside a major new software upgrade designed to integrate directly with state-level PBM complaint and reporting systems. Breck also recounts his recent meetings with state Insurance Commissioners—where he presented this breakthrough technology while PBM lobbyists pushed back in real time, leaving community pharmacy with only one v
Cutting Through the Noise: A nuanced discussion on MFN, Rebates, and Premiums | PBM Reform
Dr. Robert Popovian is a pharmacist, and economist with a deep background in research and public policy. In this episode we have a nuanced discussion on policy impacting pharmacy including PBMs, President Trumps Most Favored Nation Executive Order, Rebates, and insurance premiums.
Links to resources referenced in discussion:
• Pioneer Institute, 340B tool: https://pioneerinstitute.org/340babu
PBM Reform and the AMA | PBM Reform
In this episode, we sit down with the President of the American Medical Association to discuss PBM reform and its impact on patients, physicians, and the future of healthcare. From drug pricing transparency to ensuring access to needed medications, this conversation explores why PBM reform is at the center of today’s healthcare policy debates.
Behind the Policy: PBMs, Drug Pricing & Telehealth with Conor Sheehey | PBM Reform
Join our co-hosts Todd Eury and Greg Reybold in this exclusive interview with Conor Sheehey, who most recently served as senior health policy advisor to U.S. Senate Finance Committee Chair Mike Crapo (R-ID). In this role, he advised the Committee on a range of health care policy issues, including prescription drug pricing, telehealth, AI, provider coverage and reimbursement, fraud and abuse, medic
Cracking the Concentration: PBMs, Power, and the Fight for Fairness | PBM Reform Podcast
In this relaunch of the PBM Reform Podcast, Greg Reybold returns with a powerful and timely conversation exploring how concentrated economic power—particularly in the form of Pharmacy Benefit Managers (PBMs)—is undermining fair access to prescription medications, driving up drug costs, and crushing independent pharmacies.
Greg is joined by Emma Freer, Senior Policy Analyst with the American Eco
Certifying the Future: Dr. William Soliman and the Rise of Medical Affairs | PBM Reform
Dr. William Soliman is the founder and CEO of the Accreditation Council for Medical Affairs (ACMA). The ACMA is America’s leader in life sciences accreditation, certification & training. Soliman is a former pharmaceutical executive who worked in leadership roles at Merck, Abbvie, Gilead and more. He is considered a pharma industry futurist and has been featured on NewsNation, Fox News, Newsma
PBM Transparency, Is It Real? | PBM Reform Podcast
An insider’s look at the games PBMs play to hid fees and tack profits for community pharmacies. What a true transparent PBM should look like and why it matters.
PBM Strategies for the State of Arizona | PBM Reform
Interview with the new CEO of the Arizona Pharmacy Association, Garet Turner
Patients Before Monopolies Act | PBM Reform Podcast
In this critical episode of the PBM Reform Podcast, we are joined by two influential voices leading the charge against abusive pharmacy benefit manager (PBM) practices:
State Representative Jake Auchincloss – Congressman from Massachusetts’ Fourth District
Greg Reybold – Vice President of Healthcare Policy & General Counsel, American Pharmacy Cooperative, Inc.
Topics Discussed:
The "Pha
PBM Reform at the State Level | PBM Reform
An update from NDPhA and PBM Reform initiatives.
Coverage is not Care with David Balat | PBM Reform Podcast
Openness. Competition. Transparency.
Unmask the twisted economics of the American health care system.
Price discovery — prior to care — allows patients to shop for care in a competitive market. It empowers them with the information they need to reduce their healthcare costs. And it encourages providers and insurers to compete for their business.
Report: Free2Care’s Rx for Reforming America’s Pr
Pennsylvania Moves Forward with PBM Reform | PBM Reform Podcast
Pharmacy owner Tom DePietro, PharmD and Pennsylvania State Representative Jessica Behnam join the PBM Reform Podcast to discuss the major win for Pennsylvania tax payers and Pharmacy Care.
HB 1993 is the result of bipartisan efforts – led by state Rep. Jess Benham (D-36) – to ensure that Pennsylvanians are no longer being screwed and that access to local, independent pharmacies is maintained.
G
Broken Insurance & the Loss of a Son | PBM Reform Podcast
Special Guests:
Shanon Schmidtknecht & Loretta Boesing
Cole Schmidtknecht was a 22-year-old young man living in Appleton, Wisconsin who loved video games and sports. His parents Bil and Shanon described him as an inspirational free spirit with a love for being heard. Cole was diagnosed with severe asthma at only a year old. He had just recently moved out on his own with opportunities to cha
If You Can't Beat Them, Don't Join Them? | PBM Reform
The PBM Reform Podcast on the Pharmacy Podcast Network, with your host, Breck Rice! Breck has had the privilege of being around and working with pharmacies for over 20 years! He loves community pharmacies and will do everything in his power to help them be successful. It’s a privilege to be involved in reforming the industry he loves. Today's guest is Kyle McCormick, owner of Blue Berry Pharmacy,
The Role PBMs has in Driving Up Drug Costs for Patients | PBM Reform
Interview with Howard Danzig, President of Employers Committed to Control Health insurance Costs.
What is Congress doing to help with PBM Reform? | PBM Reform
Are the PBMs a threat to Public Health? | PBM Reform Podcast| PBM Reform Updates
Anthony V. Minniti, RPh FACA joins the PPN on the PBM Reform Podcast to talk about why the PBMs, in their current state need to be removed from pharmacy care.
As drug prices soar, the White House is taking action by hosting a pivotal listening session on Monday, aiming to dissect and potentially reform the practices of pharmacy benefit managers (PBMs). This roundtable will unite federal represent
The Volunteer State takes a Stand on PBMs | PBM Reform
Featuring Tennessee State Senator & Pharmacist Shane Reeves
"The Volunteer State" has been a Tennessee nickname since the 19th century but wasn't officially voted on until February 2020. Tennessee sent 1,500 volunteer soldiers during the War of 1812, and the nickname stuck.
Requiring PBMs to contract with rural independent pharmacies: In Tennessee, there are 70 counties considered rural out
PBM Reform Efforts Stalled in Congress | PBM Reform
In the Senate, there are 3 committees that have advanced legislation on PBM reforms, with leadership supporting a floor vote before the end of 2023. In the House, a consolidated bill was released in September and although there are plans for a full House vote, they are stalled due to the current issues in Congress.
There are 3 key jurisdictions and proposed plans of the Senate that focused on in
MISSION CRITICAL: Reform the Mysterious PBM System with Antonio Ciaccia | PBM Reform
Antonio Ciaccia is the President of 3 Axis Advisors. He was born and raised in pharmacy, Antonio has been crawling around pharmacies his entire life. After three years as a pharmacy technician and two years of pre-pharmacy curriculum, Antonio diverted course, graduating from The Ohio State University in 2007 with dual degrees in communications and political science before moving into the world of
Reigning In Out of Control Drug Costs | PBM Reform Podcast
Our special guest Wendy Barnes, CEO of RxBenefits and Mark Campbell, the VP of RxBenefits.
From BenefitsPro:
https://www.benefitspro.com/2023/03/27/how-dispelling-mistrust-of-generics-will-help-patients-and-plan-sponsors/?slreturn=20240222125659
Health care spending in the United States has increased substantially the past few years, and it isn't likely to slow down any time soon. At this rate
Titans for PBM Reform: Loretta Boesing & Antonio Ciaccia | PBM Reform
House Energy and Commerce Committee cleared a PBM bill that seems to contain more transparency loopholes and makes more limited policy tweaks to the drug supply chain middleman than the Senate HELP Committee’s bill, but the House-side legislation would pull back the curtain on specialty-drug reimbursement in a way the Senate version does not.
Two titans of PBM Reform join us today, returning gue
Alan Rosenbloom | SCPC | PBM Reform Podcast
Let's talk about the current state of the industry.
Senior Care Pharmacy Coalition: SCPC just missed getting the LTC Pharmacy Definition passed last year. The PBM issues continue, even with gov't interest and involvement.
Let's discuss LTC pharmacy's value to dual-eligibles, and how some simple policy changes would improve care for this population and save the system millions of dollars, overal
FTC Cornering PBMs to Improve Pharmacy Care | PBM Reform
Special Guest:
Lindsay Bealor Greenleaf, J.D., M.B.A.,
Vice President and Head of Policy with ADVI Health Inc.
Why now: This week U.S. Sens. Chuck Grassley (R-IA) and Maria Cantwell (D-WA) introduced two bills that seek to hold pharmacy benefit managers (PBMs) accountable for opaque practices that contribute to high drug prices for consumers.
Expert commentary: Lindsay Bealor Greenleaf, J.D., M
Did Tricare & Express Scripts put profits over patient care? | PBM Reform Podcast
The Express Scripts decision removes the option for Tricare beneficiaries to get prescriptions at the pharmacies of their choice. The National Community Pharmacists Association (NCPA) CEO B. Douglas Hoey, PharmD, MBA, warns that “access to needed medications for Tricare beneficiaries is in peril.”
This decision is estimated to impact hundreds of thousands of beneficiaries relying on certain pha
How will the Inflation Reduction Act Impact PBM Reform? | PBM Reform Podcast
Today we are hoping to make sense of the Inflation Reduction Act which is designed to protect Medicare recipients from catastrophic drug costs by phasing in a cap for out-of-pocket costs and establishing a$35 cap for a month's supply of insulin. And, as an historic win, Medicare will be able to negotiate prices for high-cost drugs for the first time ever.
Guests:
Mark Blum
Mark is the Executiv
Congressman Buddy Carter and General Counsel of NCPA Matthew Seiler on PBM Reform
Congressman Buddy Carter and General Counsel of NCPA Matthew Seiler on PBM Reform. On this episode of the 'PBM Reform Podcast' we discuss the Pharmacy Benefit Manager (PBM) Transparency Act of 2022 (the Act) was recently proposed in the U.S. Senate and intends to incentivize “fair and transparent” PBM practices, prohibit spread pricing and claw backs of payments to pharmacies, and empower the Fede
What’s the Impact of the Pharmacy Benefit Manager Transparency Act of 2022 | PBM Reform Podcast
Senator Chuck Grassley (R-Iowa) and Maria Cantwell (D-Wash.) introduced the Pharmacy Benefit Manager Transparency Act of 2022 on May 24, which would make it illegal for PBMs to engage in “spread pricing.” Spread pricing occurs when PBMs charge health plans and payers more for a prescription drug than what they reimburse to the pharmacy — and then keep the difference. For example, when a pharmacist
Pennsylvanians Suffer while Pharmacy Middlemen Profit | PBM Reform Podcast Series
Pennsylvanians suffer while pharmacy middlemen profit
By Suzanna Masartis
Pennsylvanians are getting crushed by the costs they face at their neighborhood pharmacy counter. The situation has grown so bad that a shocking one in five Keystone State residents report they are unable to take their medications as prescribed due to the cost burden.[1]
As a lawmaker and an advocate who speaks to patients i
Therapeutic Alternatives, Reimbursements, and the Economic Impact of ActiveRADAR | PBM Reform Podcast Series
Dave Teckman, Executive Chairman at ActiveRADAR joins the PBM Reform Podcast series about the impact of therapeutic interchange technologies on PBM pricing & the powerful data at the pharmacist's fingertips with ActiveRADAR.
Through rigorous clinical evaluation of all drugs in over 112 therapeutic categories, ActiveRADAR first establishes which drugs are clinically equivalent and therefore therape
The Public Deserves the Truth about Pharmacy Benefit Managers with Madelaine A. Feldman, MD, FACR
Madelaine A. Feldman, MD, FACR
Dr. Madelaine Feldman is a rheumatologist in private practice with The Rheumatology Group in New Orleans, LA. She is President of the Coalition of State Rheumatology Organizations, Chair of the Alliance for Safe Biologic Medicines and past member of the American College of Rheumatology insurance subcommittee.
Dr. Feldman is a Clinical Assistant Professor of Medicine
Leaders in Pharmacy & Medical Communities Speak Out Against Damaging PBM Practices | PBM Reform
Speaking to the Pharmacy Podcast Network, Dr. Marion Mass, a pediatrician, patient advocate and founding member of the Practicing Physicians of America, spoke about the original intent of PBMs, which started in 1968, and what they’ve become today.
“PBMs were created with the vision that they would act like giant drug-buying networks, with their buying power cutting health care costs and consumers
Never Pay the First Bill | PBM Reform Podcast Series
Special interview w/ award-winning ProPublica reporter Marshall Allen, a primer for anyone who wants to fight the predatory health care system--and win.
We welcome back two patriots in PBM Reform on the interview w/ Marshall.
Monique Whitney - CEO of Pharmacists United for Truth & Transparency and PUTT President and Pharmacy Owner Scott Newman.
Every year, millions of Americans are overchar
Study Finds Potential for Billions in Prescription Drug Savings with Transparent Pricing Practices | PBM Reform Podcast
Capital Rx and 3 Axis Advisors Study Finds Potential for Billions in Prescription Drug Savings With Transparent Pricing Practices
Mandatory NADAC responses by pharmacies for 1,600 unique oral solid products could create additional savings of $1.5 billion over 10 years
Comparing generic drug costs with NADAC and Alabama actual acquisition cost, study finds $937 million in potential annual savings a
Express Scripts Fails to Defeat Louisiana Prescription Fee Suit | PBM Reform Podcast Series
LIPA v ESI: Fight for the Right to Be Paid
What happens when a state implements provider fee statutes that are officially approved by CMS but one of the big 3 PBMs still claims exemption?
Join guest host Monique Whitney with special guests Randal Johnson, JR Whaley, and MJ Terrebonne as they discuss Louisiana's legal battle with ESI over 10 cents per claim, and the ramifications this could have
Tennessee Senator Shane Reeves | PBM Reform Podcast Series
Tennessee Gov. Bill Lee signed HB 786, a comprehensive PBM reform bill that strengthens existing fair pharmacy audit laws, limits PBM adjudication fees, and prohibits a PBM from reimbursing a pharmacy less than it reimburses a PBM-affiliated pharmacy.May 30, 2019
Tennessee SB650
Present law defines "pharmacy benefits manager" (PBM) to mean a person, business, or other entity and any wholly or pa
Outcomes of Transparent PBMs V.S. the Status Quo | PBM Reform Podcast Series
What's the expected outcomes of a transparent PBM? How does a fiduciary driven pharmacy benefit management company compare to the 3 largest PBMs in the country processing more than 76% of all the prescriptions per year in the United States.
The PBM market is dominated by three major players, who together handled about 76 percent of all prescription claims in 2018, according to Drug Channels Inst
The Implications of Rutledge v. PCMA | PBM Reform Podcast Series
We talk with Community Pharmacy owner Dr. Steve Moore, PharmD about the Implications of the Rutledge versus PCMA Supreme Court decision on Independent Pharmacy.
About Condo Pharmacy:
Condo Pharmacy is an independently owned and operated pharmacy dedicated to meeting the unique healthcare needs of each individual patient. In addition to providing both traditional and specialty pharmacy services
What You Need to Know about U.S. Supreme Court Rutledge vs PCMA | PBM Reform Podcast Series
Georgia House of Representatives Earl L. “Buddy” Carter joins CEO of RxSafe Bill Holmes to summarize the The Supreme Court of The United States (SCOTUS) has rescheduled the Rutledge v. The Pharmaceutical Care Management Association (PCMA) hearing for October 6, 2020.1 The initial April hearing date had been postponed due to the coronavirus disease 2019 pandemic (COVID-19)
Rutledge v. PCMA revolve
Creative Strategies to fight the PBMs | Anthony Reznik w/ IPA
Director of Government and Public Affairs for Independent Pharmacy Alliance (IPA) Anthony Reznik joins us on the PBM Reform Podcast Series to discuss strategies Pharmacy can implement to fight the PBMs while we wait for legal reform at the state & federal levels.
Independent Pharmacy Alliance, est. 1988, is a trade group and retail pharmacy buying cooperative representing over 3,100 independent
Georgia State Representative David Knight & GPhA Greg Reybold | PBM Reform Podcast Series
Georgia Gov. Brian Kemp (R) has signed three innovative PBM reform bills into law. HB 946 and SB 313 require the reporting of drugs paid 10 percent above and 10 percent below National Average Drug Acquisition Cost every four months, prohibit PBMs from tying a pharmacy’s drug reimbursement to a patient’s health outcomes, and require PBMs to offer drug coverage plans that do not include spread prici
Antonio Ciaccia | PBM Reform Podcast
Antonio Ciaccia was born and raised in pharmacy, Antonio has been crawling around pharmacies his entire life. After three years as a pharmacy technician and two years of pre-pharmacy curriculum, Antonio diverted course, graduating from The Ohio State University in 2007 with dual degrees in communications and political science before moving into the world of association management.
Thinking tha
The Managed Care PBM Option | PBM Reform Podcast Series
A PROPOSAL FOR SMALL TOWN INDEPENDENT PHARMACISTS
A new trend has independent pharmacist = working directly with the businesses that are right there in the same community. While the small town environment is by its nature a concise marketplace, too often those local businesses get themselves into situations that does not make logical or financial success. Big insurance companies get involved, an
FL State Representative Jackie Toledo & Putt President Scott Newman | PBM Reform Podcast Series
Special Guest:
Jackie Toledo - Florida State House of Representatives 60th District
A product of Tampa’s public schools, Jackie graduated from Gaither High School and was awarded an academic engineering scholarship to the University of South Florida from the Latino Scholarship program. In 2000, she received her degree in Civil Engineering from USF and wanted to stay in Tampa so she could help
Pharmacy Reimbursements Impact on Public Health | PBM Reform Podcast Series
The seventh episode in the PBM Reform Podcast Series features guest host Monique Whitney, the Excutive Director of Pharmacists United for Truth and Transparency (PUTT) interviewing pharmacy owners, Oliver's Express Pharmacy Oliver Lackey, PharmD and Main Street Pharmacy Owner, Jeremy Counts, PharmD.
Two major trends are driving decreasing reimbursement to pharmacies: DIR fees and copay clawbacks
The Unregulated PBM is a Danger to Public Health | PBM Reform Podcast Series
Pharmacists are trapped in a system that threatens patient safety.
Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA APhA Executive Vice President and CEO writes: If you ask me what keeps me up at night, I’d say it’s the kinds of mistakes that Ellen Gabler described in her January 31 New York Times story, “How Chaos at Chain Pharmacies Is Putting Patients at Risk.” During my time as a community
A Pharmacy Owner’s Perspective | PBM Reform Podcast Series
On the 5th interview of the PBM Reform Podcast Series we talk with Scott Pace, Pharm.D., J.D. pharmacy owner and advocate for PBM Change.
Scott is a Partner at Impact Management Group where he focuses on the Government Relations and Public Affairs practice areas.
Scott joined IMG following more than 12 years with the Arkansas Pharmacists Association, most recently serving as the organization’
IN DATA WE TRUST: | PBM Reform Podcast Series
IN DATA WE TRUST
Special Guest: ANTONIO CIACCIA with 3 Axis Advisors.
Born and raised in pharmacy, Antonio has been crawling around pharmacies his entire life. After three years as a pharmacy technician and two years of pre-pharmacy curriculum, Antonio diverted course, graduating from The Ohio State University in 2007 with dual degrees in communications and political science before moving int
The Impact on Employers & the Pass-Thru PBM Option | PBM Reform Podcast Series
On Part Three of the PBM Reform Podcast Series we talk with Mary Ellen S. Jones a PSEA UniServ Representative and Anthony J. Loiacono / Chief Executive Officer of Capital Rx, a pass-thru Pharmacy Benefit Management company.
PSEA is 181,000 members strong – a community of education professionals who make a difference in the lives of Pennsylvania’s students every day.
PSEA members are teachers,
Pharmacists for Truth Transparency - PBM Reform Series Part Two - PPN Episode 906
Part Two of the PBM Reform Podcast Series features an interview with Monique Whitney, the Excutive Director of Pharmacists United for Truth and Transparency (PUTT).
Pharmacists United for Truth and Transparency (PUTT) is a non-profit advocacy organization founded by independent pharmacists and pharmacy owners devoted to exposing the truth about the anti-competitive tactics of pharmacy benefits m
PBM Reform Series Part One: NCPA INSIGHTS - PPN Episode 902
Anne CassityVice President, Federal and State Government Affairs at National Community Pharmacists Association (NCPA) joins Todd Eury, CEO of the Pharmacy Podcast Network, on part one of the new series:
PBM Reform Podcast Series
Pharmacy benefit managers were created as middlemen to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negoti
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