I can understand why PBMs reimburse us mere pennies above cost. I can, somewhat understand why they refuse to pay fees.
What I do not understand, however, is why they refuse to pay the tax on a drug.
You see in one of the states I have worked in, I keep tabs on my prior employers, many of the PBMs have decided they will not pay for the state tax on the prescriptions we fill. They leave it 'up to the pharmacies' to deal with as one kind PBM rep told an ex-coworker of mine.
The kicker is according to that particular state law, the PBM has to pay the taxes enforced by the state. Yet some how, they're allowed to get away with not paying it.
They are then left with the tax amount and are forced to make the patient pay for it. It is not something that normally I would condone, but seriously what else can you do?
My question is how is this acceptable? Several of the patients who have asked why this has happened have been completely livid with their provider. One of which, apparently, left his work plan and opted to go to a private plan instead.
Apparently if you are a PBM you can get away with no paying taxes. You know what would happen if I chose to not pay my taxes? Well let's just say I may be sharing a tiny room with a guy named Bubba and a lack of Astroglide at night.
So I have decided, on this glorious spring day, that I will now be a PBM instead of a pharmacist. Judging from experience, I will be able to boss everyone around and not have to do anything that I don't want to do. The money I earn will come at the expense of those around me. This, of course, includes when logic stands in my way.
And of course, I will be free of paying taxes. Because, damnit I won't want to. And since I'm a PBM, if I don't want to do something, I don't have to do it.
Right?
4 comments:
Ok, not to be a jerk or anything but as a PBM employee/pharmacist I am going to let you in to a little secret about pharmacy claims and sales....
They are ALL exempt from State taxes.
???
That's news to me. I've had two different employers in that state tell me otherwise.
I hope you inform your members that they'll have that $10 copay.... and then have to pay 3% (or whatever it is) of the total cost
Perhaps it varies by state? Here, there is no sales tax on prescriptions for humans, but there is on animal prescriptions.
And I'm sure the laws that let them not pay sales tax when they're required to are the same laws that let Walmart refund you the local sales tax when you return an item, instead of refunding you the (higher) sales tax that was paid at the next county's Walmart on the original purchase.
Again, who is supposed to pay the tax? When we make ~$2 on something that costs $500, how are we supposed to recoup that?
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