Pharmacist-Lawmaker Refiles Pharmacy-Related Bills: Conflict of Interest?

December 31, 2014

Investigative Reports

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By RICK BRUNDRETT

PillsIf you ask state Rep. Kit Spires, he’ll tell you his primary focus as a lawmaker is not to push pharmacy legislation.

Yet the Lexington County Republican, who is a licensed pharmacist and pharmacy owner, this month re-introduced three pharmacy-related bills that will be taken up when the General Assembly reconvenes on Jan. 13.

  • H. 3159, titled the “Pharmacy Patient Protection Act,” would require pharmacy benefit managers (PBMs), who, as defined in the bill, manage prescription drug benefits provided by a health insurer, health maintenance organization or nonprofit hospital or medical service corporation, to be registered with the S.C. Department of Insurance; not doing so could result in fines of up to $10,000 per violation. Under the legislation, a PBM “shall not intervene in the delivery or transmission of prescriptions from the prescriber to the pharmacist or pharmacy for the purpose of,” among other things, “influencing the patient’s choice of pharmacist or pharmacy.”
  • H. 3160 would require that products containing ephedrine, pseudoephedrine or phenylpropanolamine – often used in over-the-counter decongestants – be sold only “upon the prescription of a physician or a person licensed pursuant to Title 40 who has prescriptive authority,” and that a “pharmacist shall store and maintain these medications in accordance with applicable state and federal law.”
  • H. 3161 would impose new regulations on “compounding” pharmacies, or pharmacies that mix or modify medications to fit the particular needs of patients. Under the bill, pharmacists “engaged in the compounding of drugs shall operate in conformance with applicable laws regulating the practice of pharmacy.”

Asked Tuesday by The Nerve if his bills would benefit his pharmacy – Big S Discount Drugs in Pelion – Spires replied, “Not necessarily.”

When contacted initially in 2013 by The Nerve, Spires denied he had any conflicts of interest in sponsoring pharmacy-related legislation.

“These are not personal bills of mine. … It benefits all pharmacists and not just me,” Spires said at the time, adding, “I respond to the needs of people in my district and other pharmacists in the area.”

A review by The Nerve then of legislation sponsored by Spires since his first year as a House member in 2007 found that of 22 general bills, seven, or nearly a third, were pharmacy-related. Of the five general bills and one joint resolution prefiled this month by Spires, three are pharmacy-related.

State ethics law (Section 8-13-700 of the S.C. Code of Laws) bans public officials from using their positions to “obtain an economic interest for himself, a family member, an individual with whom he is associated, or a business with which he is associated.”

But there’s a loophole that lawmakers frequently use in proposing legislation affecting their businesses: Under Section 8-13-100 (11) (b) of state law, commonly referred to as the “large-class exception,” lawmakers can introduce bills that benefit their businesses if the legislation also would help other similar businesses equally.

Spires introduced the same three pharmacy-related bills over the past two-year legislative session, but because none of the legislation passed, he said he had to re-introduce the bills for the new two-year cycle that starts next month.

Spires said he sponsored the bill requiring the prescription of medications containing ingredients typically used in decongestants because “we have a real problem in the United States with meth (methamphetamine) production,” adding he doesn’t “sell a lot of pseudoephedrine” at his pharmacy. As for the bill setting new regulations for compounding pharmacies, he said he is “just trying to get South Carolina in with national standards.”

Spires, who turns 61 in February, pointed out he re-introduced several other non-pharmacy bills this month, including legislation that would eliminate property taxes for home owners who are at least 65 years old.

“My primary purpose (in introducing legislation) is not pharmacy,” he said.

In its 2013 story, The Nerve reported that Spires had not listed his pharmacy ownership on his annual statement of economic interests filed with the State Ethics Commission. He reported it for the first time in March of this year.

The South Carolina Policy Council – The Nerve’s parent organization – in 2012 called for the reporting of public officials’ private sources of income, though not amounts, as part of its eight-point reform agenda. Last year, the Policy Council launched “Project Conflict Watch” to encourage state lawmakers and other officials to voluntarily report their private-income sources.

The Nerve reported last year that Spires did not list any Medicaid payments received by his pharmacy on his annual statements of economic interests, though other lawmakers reported Medicaid payments to their businesses. State records show Spires’ pharmacy received nearly $250,000 in Medicaid payments for prescription drugs and durable medical equipment from April 2012 through April 2013.

It was not known by publication of this story how much in Medicaid payments his pharmacy received last fiscal year, which ended June 30, or so far this fiscal year. Colleen Mullis, spokeswoman for the S.C. Department of Health and Human Services, which administers the state’s Medicaid program, told The Nerve on Tuesday that she couldn’t provide any immediate answers, noting the agency recently had “switched systems” and was short-staffed with the holidays.

The Nerve on Tuesday wanted to question Spires about Medicaid payments to his pharmacy but didn’t get the chance because he said he had to get back to work.

“I will talk to you after session starts,” Spires quickly said before ending the call.

Reach Brundrett at (803) 254-4411 or rick@thenerve.org. Follow him on Twitter @thenerve_rick. Follow The Nerve on Facebook and Twitter @thenervesc.