PA| The Pennsylvania Insurance Department issued Notice 2025-07 in response to questions about prescription drug access following Rite Aid’s bankruptcy and store closures. The notice directs insurers and pharmacy benefit managers (PBMs) to ensure continued patient access to prescription medications by meeting network adequacy standards, facilitating smooth prescription transfers, and exercising flexibility in pharmacy audits to avoid hampering patient services. The Department expects prompt communication of any network gaps, supports for affected patients, and a focus on uninterrupted access to necessary medications.
Key Points:
- Continuity of Care: Insurers and PBMs must maintain adequate access to retail pharmacies for all affected patients, ensuring compliance with state and federal network adequacy standards even in areas impacted by Rite Aid closures.
- Patient Support and Notification: Insurers and PBMs should offer dedicated support (e.g., hotlines, web portals) for prescription transfers, notify patients of pharmacy closures, and ensure that prior authorizations and drug exceptions are smoothly transitioned without requiring new approvals.
- Flexible Approach to Pharmacy Audits: PBMs conducting pharmacy audits should delay or adapt audit procedures to avoid interfering with pharmacy operations or patient care during this period of increased demand at other retail pharmacies.