Kristin Tawater

[Mississippi State Football @HailStateFB]

Nothing But Good Times Over Here, Boys 🤠

@PatMcAfeeShow x @realjknoxville

[Stock Mom™ @stockmom]

I can't stop listening to this song. Best thing that came out of the World cup being in the United States this year. 🇺🇸

Watching this compilation of fans from all over the world at the 2026 World Cup in America is so heartwarming.

USA USA USA 🇺�

[Robbie Faulk @robbiefaulk1878]

Loved these thoughts from Jacob Parker postgame.

The freshman talks about his Faith, the leadership of the coaching staff and Aidan Teel helping him this year.

[Mississippi State Baseball @HailStateBB]

Bryce Chance. Dawg.

[Shane Power @shanepower21]

Truth!!!

[NCAA Baseball @NCAABaseball]

🚨 2026 DI Baseball Regional Host Sites 🚨

👉 https://t.co/4UMGre4vOL

The 16 sites are listed in alphabetical order.

#RoadToOmaha

[Kristin Tawater @k_miller11]

@MrCoachTbratt How are you getting him to OKC???

[SEC Network @SECNetwork]

"An underdog is still a freakin' dog." 🐶

Delainey Everett and @HailStateSB got that DOG in them 🔥

[Mississippi State Softball @HailStateSB]

DAWGS WIN AGAIN!

#HailState || #OKCDawgs

[Mississippi State Softball @HailStateSB]

Don’t worry, Dawgs. He made it!

#HailState

[Mississippi State Softball @HailStateSB]

DAWGS DO NOT QUIT!

#HailState

[Kristin Tawater @k_miller11]

Chills

[KJ Reid @_KJReid_]

My first Super Bulldog Weekend, and I got the opportunity to shoot a grand slam. The crowd pop. There is nothing like Dudy Noble Field.

Grateful.

[Pittsburgh Pirates @Pirates]

Special day after a special moment. 🖤💛

[KP, Pharm.D. @kpharmd12]

Asking @grok the hard hitting questions:

A “pill tax” is a rhetorical term used by PBM opponents to describe proposed minimum pharmacy reimbursement rules—typically requiring PBMs to pay pharmacies at least the National Average Drug Acquisition Cost (NADAC) for the drug ingredient plus a professional dispensing fee (e.g., $10.50 or the state Medicaid rate). Critics claim this would act like a new tax, driving up prescription drug spending (one estimate floated a nationwide $16 billion annual increase) and therefore raising what employers pay in premiums and what patients pay at the pharmacy counter via higher copays or coinsurance.

THIS IS A MYTH.

It misrepresents how costs actually flow in the current PBM-dominated system and ignores that PBM practices like spread pricing and DIR (Direct and Indirect Remuneration) fees already inflate spending for employers, plans, taxpayers, and patients far more than any transparent dispensing fee ever could. Mandating NADAC + a fair dispensing fee (paired with bans on spread pricing and retroactive claws) is a move toward pass-through transparency that removes hidden PBM profits without netting higher costs to patients or employers. Here’s the side-by-side comparison based on documented PBM practices and state-level evidence.

Current PBM Pricing Schemes: The Real Cost Drivers Today
PBMs (the three largest control ~80% of the market) act as middlemen for employers, insurers, and government programs. Their incentives are misaligned with patients and plan sponsors:

- Spread pricing: The PBM reimburses the pharmacy less than it bills the employer/plan for the same claim and pockets the difference as profit. Example: Pharmacy gets paid $80; PBM bills the plan $100; PBM keeps $20. This is not pass-through—it is built-in overpayment by the plan.

- Impact on employers/plans: Direct inflation of drug spend. Audits and investigations have shown PBMs overcharged Medicaid programs by hundreds of millions (e.g., Ohio ~$225 million in one case; multiple states >$415 million combined). The three largest PBMs generated an estimated $1.4 billion in spread income on just 51 generic specialty drugs over ~5 years.

- Impact on patients: Higher premiums flow from inflated plan costs. Patient cost-sharing (copays/coinsurance) is often calculated on the higher PBM-billed amount, not the actual pharmacy payment. Pharmacies are frequently reimbursed below acquisition cost, leading to closures (especially independents), reduced access, and patients traveling farther or paying cash prices.

- DIR fees (retroactive claws): PBMs charge pharmacies “performance” or network fees months after the claim is filled. These are not applied at the point of sale.

- Impact on patients: Copays/deductibles are calculated on the pre-DIR (inflated) price. This accelerates patients into the Medicare Part D donut hole faster and raises true out-of-pocket costs with no later rebate to the patient. CMS has noted DIR fees increase beneficiary and taxpayer costs because the negotiated price used for cost-sharing does not reflect the final net amount.

- Impact on employers/plans: Plans pay the higher upfront amount; DIR fees do not flow back as savings to the sponsor. Pharmacies absorb losses (sometimes net-negative reimbursement), which gets passed on indirectly through higher list prices or fewer pharmacies in network.

These practices are opaque by design. Employers often cannot audit them fully, and PBM compensation is sometimes tied to list prices or rebates rather than net savings. The result: rising premiums, higher patient cost-sharing, and pharmacy viability crises—exactly the outcomes the “pill tax” myth warns about, but already happening today under PBM schemes.

The real “pill tax” on employers is the current PBM system’s hidden spreads, DIR claws, and lack of transparency—practices that have been audited and litigated for overcharging plans by hundreds of millions while squeezing pharmacies.

[Kristin Tawater @k_miller11]

@SarahHuckabee independent pharmacies in Mississippi are struggling. We look up to AR with the passage of legislation last year from y’all. Is there any encouraging words you can give us. Tomorrow is the deadline for our HB1665 bill and we can’t get it to the floor in the house.

[Sarah Adlakha @SarahAdlakha]

PBM Reform

HB 1665 is back in the Mississippi House.

Call your House Representative and ask them to vote YES on Mississippi House Bill 1665.

Also call House Speaker Jason White and ask him to bring HB 1665 to the floor for a vote.

📞 Mississippi House Switchboard: 601-359-3300

Tell them:
“Please support HB 1665 and protect Mississippi pharmacies.”

#mississippi #politicstiktok #PBM #healthcare #healthcarereform

[The Angry Pharmacist @theangrypharm]

Says the association who's members intentionally block lower cost generics from being covered in favor of brand-name drugs because the rebates they pocket are higher.

How stupid do you think we are?

The FTC study showed you were pocketing billions in rebates. Does the person who write this bullshit even know what a PBM is?

[Mark Cuban @mcuban]

This is your heads up about the new scams that PBMs and their related companies are pulling.

It is built on the following premise

"Whoever controls care decisions controls revenue."

The new "Rebate GPO" from PBMs is charging PEPM or PMPM fees to employers for "clinical services" .

Can someone explain to me any scenario where a Pharmacy Benefit Manager would be the best source of clinical management services like the following :

(PMPM)

Specialty Drug Management
$10 – $100
Coordination of specialty medications, utilization review, patient monitoring

Digital Health / Remote Care Programs
$20 – $40
Virtual care platforms, chronic disease apps, coaching programs

Care Navigation Services
$5 – $15
Member guidance, provider steering, benefits assistance

Medication Adherence Programs
$3 – $10
Outreach programs designed to improve prescription compliance

Clinical Analytics & Employer Reporting
$2 – $8
Data dashboards, utilization analysis, predictive modeling

Prior Authorization Administration
$1 – $5
Processing and management of prior authorization requests

Biosimilar Conversion Programs
$5 – $20
Drug switching initiatives and manufacturer coordination

Outcomes / Value-Based Contract Administration
$2 – $6
Tracking clinical outcomes tied to manufacturer agreements

I'll say it again. The new PBM scam is to control care decisions

WHOEVER CONTROLS CARE DECISIONS CONTROLS YOUR BENEFITS BUDGET. AND IT WONT BE YOU. IT WILL BE YOUR PBM

You have been warned.

@RepBuddyCarter @HawleyMO @SenWarren @RubenGallego @jamestalarico @SenSchumer @RFKJr_Official @modrnhealthcr @RosenthalHealth @chrisklomp @DrOz

[Mississippi State Baseball @HailStateBB]

The next chapter begins 𝙣𝙤𝙬

[Kristin Tawater @k_miller11]

@sterlingkoonce I have $18000 (last I looked) tied up right now. Only received around $5000 in payments so far since 1/2.