Independent pharmacies face immense pressure from Pharmacy Benefit Managers (PBMs), often confronting the impossible choice of losing money on a prescription or turning a patient away. In this episode of The PUTTcast, host Lauren Young sits down with Kris Rhea from Pharmacy Marketplace to discuss a game-changing solution to this "pharmacy spiral." They dive deep into the world of MAC appeals and underwater claims, revealing how new software helps pharmacy owners fight back and reclaim rightfully owed revenue. Whether you’re navigating new state statutes or tracking the PBM divestiture bill in Tennessee, this episode offers actionable insights and a powerful tool to strengthen your pharmacy's financial health while fueling the momentum for nationwide PBM reform.

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

In this month’s special episode of The PUTTcast, we’re gearing up for the highly anticipated PUTT Virtual Summit! Join host Lauren Young, PUTT Executive Director Monique Whitney, and special guest advocates Nikki Bryant and Rosemary C Smith as they explore the critical strategies independent pharmacies can use to amplify their voices and drive meaningful change. From building political connections to fostering trust within your community, listen in as they discuss how independent pharmacy owners can take charge of their advocacy efforts and make a lasting impact.

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

Illinois has scored a monumental win for patients and pharmacies with the passage of HB 1697. This episode dives into the legislation’s groundbreaking PBM reform and unravels how, through bipartisan effort, it amplifies transparency, protects patients and pharmacies by securing fairer practices, and puts the needs of Illinois communities first.

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