Legislators say that language in Pennsylvania’s now passed budget will benefit a local pharmacy in their over yearlong battle with pharmacy benefit manager Express Scripts.
It’s been roughly one year since Express Scripts terminated Martella’s from its contract and new language in this year’s budget could reportedly help get the pharmacy back into the network, benefiting hundreds of patients in the area.
While representatives from Martella’s say this is a step forward in their battle, they note that there is still a lot of work to be done to return to Express Scripts’ network.
Legislators explained that language was inserted into the fiscal code in this year’s budget that will provide Martella’s Pharmacy with a pathway to become re-instated by the PBM.
Both local lawmakers and representatives from Martella’s say this new language is a step in the right direction.
“We were able to get this language in the budget that basically says that if you’ve sat out a year, you’re able to reapply within 12 months of being terminated, so Martella’s will now be able to apply again to be reinstated,”
“This is assuming that they are in good standing, then the PBM Express Scripts cannot deny that. This is forceful language which makes it very clear that if you have a provider such as Martella’s, then they need to be afforded that opportunity to provide for those individuals,”
That network termination has impacted hundreds of patients across Cambria and Somerset counties, many who have said that they need the services that Martella’s provides. Legislators say they have also heard that call for help.
“This is something that we have been working on for some time. We’ve heard a lot of outreach from a wide range of people on this issue for over a year now, well over a year, and we’ve been dealing with this and have been working with stakeholders that have been involved and have been working to craft legislation, as well as talk to stakeholders as well as talk to these PBMs; it’s been a very long process,”
“The real effort comes from the people of the community, the patients of Martella’s and the people that were concerned about losing a business that has been there for 60 years; those are the people that actually made this happen because they’re the ones that got the attention of the folks in Harrisburg,”
While those legislators say this is now law and the pharmacy can be reinstated with Express Scripts, representatives from Martella’s say that the work is not done yet.
In a statement issued Sunday, Martella’s said in part, “while today’s news is an important and encouraging milestone, our work is not yet complete. We are carefully reviewing the final legislation to better understand the next steps and what it means for our patients and our communities.”
Martella’s says “their focus remains on restoring access for the thousands of Medicaid patients who have been impacted and ensuring that the intent of this legislation becomes a reality.”
The pharmacy also thanked patients, employees, elected officials and those who have stood by them through this time, and they encourage the community to continue sharing their stories while they continue to work towards re-instatement with the PBM.
We have reached out to Express Scripts for comment but have not heard back.