Local pharmacists look to Congress to help loosen Rx squeeze

Pharmacist Nasir Mahmood, Pine Plains Pharmacy, is advocating for independent community pharmacies to allow them to continue serving their communities.
Leila Hawken

Pharmacist Nasir Mahmood, Pine Plains Pharmacy, is advocating for independent community pharmacies to allow them to continue serving their communities.
Local pharmacies are historically central to community life and have been for generations. If they offered a soda fountain counter with round swivel stools, so much the better.
Today’s family pharmacists throughout the area, however, are struggling under an oppressive pharmaceutical insurance middleman system that strips away profit from their prescription counter.
Beginning in the 1960s, Pharmacy Benefits Managers (PBMs) came upon the scene to process drug claims for insurance companies. By the 1970s they were serving as middlemen between manufacturers, insurance companies and pharmacies, adjudicating prices.
Today, PBMs not only adjudicate claims, but now they develop and manage pharmacy networks, determine the list of drugs to be covered by insurance, set co-pay amounts and serve to channel the patient to a particular choice of pharmacy.
According to the Pharmacists Society of the State of New York (PSSNY), PBMs can own their own pharmacies, retail and mail order, and profit from sales and services. The work of the PSSNY is to propagate and protect community pharmacies.
The effect of this progression as PBMs have become “invisible middlemen” has been devastating to local family-owned pharmacies in area towns in New York and Connecticut, endangering their existence and the invaluable service they provide to their patients and the communities they serve.
Today, the three largest PBMs control nearly 80% of the prescription benefits market share in the U.S., according to the PSSNY.
“We are so lucky to have this pharmacy. It’s a blessing,” said Pine Plains resident Ann Noone, a regular customer of the Pine Plains Pharmacy, commenting on Monday, April 8 about the local business and its pharmacist. “He’s done a lot for this town.”
Pharmacist at the Pine Plains Pharmacy since 1989, and owner of the historic corner drug store since 2006, Nasir Mahmood has witnessed the financial squeeze on area pharmacies with some forced to close their doors, victims of the PBM system.
It is the PBMs that pre-determine how much each drug covered under the plan should cost, and this is the amount it reimburses all pharmacies except the large-chain ones they own. Often the reimbursement rates are well below the cost of the drug, putting pharmacies in the position of having to fill a prescription at a loss.
“We cannot wait for PBM reform,” said Mahmood on Wednesday, March 27, describing the current tenuous status of bi-partisan federal legislation awaiting vote in Washington, D.C.
Having served as president of the PSSNY for two years in 2008-09 and having finished a two-year term as chairman of the PSSNY Board in March, Mahmood now continues as a member of that board. He also serves on the National Legislative Committee within the National Community Pharmacists Association (NCPA) working with other pharmacists’ professional organizations promoting new legislation to place limits on PBMs and create an equitable structure of reform and accountability.
Bipartisan bills have passed out of committee and are awaiting floor vote that would provide strict regulation and transparency to the work of the PBMs, improve patient access and lower costs, Mahmood said. The NCPA has achieved some recent success in the long process of bringing bills to the floor for a vote.
A series of Senate and House bills received bipartisan support and convincing vote margins as they emerged from committees. With passage, the various pieces of legislation would bring lower drug costs, greater transparency in the process, require the Centers for Medicare and Medicaid Services (CMS) to define their contract terms, and require PBMs to operate with greater transparency.
The legislation was attached to the government funding package that was passed in late March to avoid a government shutdown, but Mahmood said that at the last minute the PBM bills were stripped out of the package.
Continuing their commitment to PBM reform, however, Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) pledged to press on with efforts to enact the legislation before the end of this congressional year.
The NCPA further reported that on Friday, March 22, a bipartisan group of 21 senators and 51 house representatives signed a letter to their respective leadership, asking for immediate action on PBM reform measures.
Advocacy groups are actively pursuing passage of the legislation having arranged a conference drawing pharmacists from across the U.S. to the national headquarters of the NCPA in Alexandria, Virginia, for a two-day meeting to begin on Wednesday, April 17.
“We’ve come a long way with continued advocacy year after year,” Mahmood said, contemplating his participation in the upcoming meeting. Senators and representatives will be reporting to the conference and encouraging continued advocacy strategies to promote passage of the bipartisan PBM legislation.
One bill would bring transparency to Medicaid drug pricing with annual savings of $1 billion. Another would remove PBMs from negotiating CMS services, and the third would provide for greater transparency, oversight and enforcement through the Federal Trade Commission (FTC).
Independent pharmacies throughout the area have expressed their concern about the issue and joined in the hope that the current efforts toward passing legislation will be successful.
Meanwhile, local and area pharmacists remain in the balance, squeezed by the PBM system and locked out of the price negotiation process. During an interview, Mahmood noted that there is not one independent community pharmacy left open in Columbia County.
“It’s not fair,” he said.
Sharon Hospital
SHARON — Northern Dutchess Paramedics will cease operating in Northwest Connecticut at the start of the new year, a move that emergency responders and first selectmen say would replace decades of advanced ambulance coverage with a more limited service arrangement.
Emergency officials say the change would shift the region from a staffed, on-call advanced life support service to a plan centered on a single paramedic covering multiple rural towns, raising concerns about delayed response times and gaps in care during simultaneous emergencies.
The decision became known on Dec. 11, when communities were informed that NDP’s service would end as of Jan. 1, according to Andrea Downs, president of the Falls Village Volunteer Fire Department and an employee of the organization.
Founded in 1994 and based in Rhinebeck, New York, NDP has provided advanced and basic life support ambulance services to communities in Dutchess and Columbia counties in New York, as well as parts of Litchfield County, for nearly three decades.
How the change came about was outlined by Al Tortorella of Sharon, also an employee of NDP.
Tortorella said every Connecticut municipality is required to have an advanced life support provider. For the past 28 years, Sharon Hospital has fulfilled that requirement by signing an annual hospital-sponsored agreement with NDP. In recent years, the agreement was signed by Dr. Ronald Santos, head of the hospital’s emergency department, under whose medical license NDP operates.
When NDP recently approached Santos to renew the agreement, he said he could not sign it, a decision that took the organization by surprise, Tortorella said.
Area towns operate volunteer ambulance squads that provide basic life support. NDP supplements those crews by delivering advanced medical care, administering medications and conducting inter-facility transports.
Sharon Hospital, which is part of Nuvance Health, merged earlier this year with Northwell Health. Downs and Tortorella said they understand that the hospital system plans to replace NDP with its own paramedic service.
Under the proposed arrangement, a single paramedic would cover the Sharon Hospital catchment area, starting each 12-hour shift in New Milford before traveling to Sharon. If needed, the paramedic would be assisted by a paid EMT provided by Nuvance.
Tortorella sharply criticized the model.
“It’s a system designed to fail,” Tortorella said. “This is a huge issue.”
Downs echoed those concerns, noting that the paramedic’s 12-hour shift would include significant travel time between locations.
“I’m very concerned about the health and well-being of residents in the Northwest Corner,” she said. “We don’t want any reduction in services for patients in the region. I can’t understand the rationale of taking services away. Northwell wants to maintain a model of corporate health care, but they can’t put a face to the people and culture we’ve established here. We’re talking life and death.”
Downs emphasized that the decision does not involve layoffs at NDP, which was recently acquired by Empress. She said there is ample demand for paramedic services in New York state and that employees’ jobs are secure. The concern, she said, is for the safety of families, friends and neighbors in Northwest Connecticut.
In an interview, Sharon Hospital President and CEO Christina McCulloch and Andrea Rynn, assistant vice president for community, government and public relations at Northwell Health, addressed the decision to discontinue the hospital-sponsored agreement with NDP.
“Recently, concerns were brought to our attention about compliance and [a lack of] communications,” they said. “This information left us unsettled and unable to be a sponsoring hospital at this time.”
They acknowledged that the timing of the transition was far from ideal. “Despite the tight timing, we are actively developing a coverage plan in concert with local first responders and area leaders. This is a process that is just beginning and we are confident it will strengthen over time.”
McCulloch and Rynn said the hospital and health system remain committed to maintaining service continuity and working with community partners to enhance emergency medical services across the region.
The pair have met with representatives of area ambulance squads and on Friday held a session with the region’s first selectmen.
Gordon Ridgway, first selectman of Cornwall, said people are feeling rushed by the move. They are concerned that services will be lessened, not enhanced.
“This is the most important thing in town; picking up people in the middle of the night and providing immediate care. It has to be done well.”
Falls Village First Selectman David Barger said the meeting was productive and answered some questions, but left others unresolved.
He said he plans to host a meeting in January at the town’s emergency services center, inviting ambulance providers, first selectmen and hospital representatives to continue the discussion.
Berlin High School’s football team rejoices after a last-minute win in the Class M championship game Saturday, Dec. 13.
In December’s deep freeze, football players showed their grit in state playoff tournaments.
Connecticut Interscholastic Athletic Conference named six state champions in football. The divisions are based on school size: Class LL included schools with enrollment greater than 786; Class L was 613 to 785; Class MM was 508 to 612; Class M was 405 to 507; Class SS was 337 to 404; and Class S was fewer than 336.
Eight teams qualified for each tournament and all championship games were played on Saturday, Dec. 13.
Class LL was won by Greenwich High School for the second straight year. Greenwich beat Southington High School 45-6 to win the tournament. Jack Kelly rushed in three touchdowns for the Cardinals and caught a fourth.
Class L was won by New Canaan High School, which completed an undefeated season. New Canaan beat Cheshire High School 34-13 for the school’s fourth-straight state title. In the regular season, New Canaan defeated Greenwich 14-7.
Class MM was won by Windsor High School, which defeated Bunnell High School 23-13. Windsor quarterback A.J. Robinson threw for 140 yards with a passing touchdown and two rushing touchdowns.
Class M was won in the final minute by Berlin High School 20-15 over Brookfield High School. The thriller came down to the wire. Brookfield went ahead with a late touchdown. Then on the kickoff that followed, Berlin’s Eli Rice ran it 80-yards to the house to take the lead with 33 seconds remaining and secure the state trophy.
Class SS was won by Daniel Hand High School, marking its 15th state title in school history. Hand defeated reigning champion Killingly High School 37-13. Killingly was previously on a 25-game win streak that stretched over two seasons.
Class S was won by Sheehan High School, defeating Northwest Catholic High School 21-7. Running back Joshua Durant ran for 215 yards and three touchdowns in the win for Sheehan, which was the first state title since 2019 for the school.
Details and photos from each championship game can be found at ciac.fpsports.org
Volunteers scan snowy treetops during the Trixie Strauss Christmas Bird Count in Sharon. Teams identified more than 11,400 birds across 66 species.
SHARON — Birdwatching and holiday cheer went hand in hand for the Trixie Strauss Christmas Bird Count on Sunday, Dec. 14, with hobbyists and professionals alike braving the chill to turn their sights skyward and join the world’s longest running citizen science effort.
The Christmas Bird Count is a national initiative from the Audubon Society, a globally renowned bird protection nonprofit, that sees tens of thousands of volunteers across the country joining up with their local Audubon chapters in December and January to count birds.
This wintry avian census, which is now in its 126th year, is very effective at amassing bird quantity and species diversity data, especially in colder climates where seasonal populations of birds are highly variable. These datasets, Audubon has upheld, provide vital snapshots of population health and trends, which then informs conservation strategy.
Sharon Audubon helped to host the Trixie Strauss count, the formal name of the regional count that covers an area centering on The Hotchkiss School, with staff members aiding 24 volunteers spread out over eight teams that each surveyed a unique 15-mile loop.
According to the total tally, the volunteers had identified over 11,400 birds spanning 66 species, just one less than last year’s total of 67 species.
While the number is similar, Bethany Sheffer, volunteer coordinator and naturalist at Sharon Audubon, said the species that are present are subject to change based on a number of factors. The early freeze of lakes and ponds in the Northwest Corner meant that there were fewer species that prefer open water tallied this December, Sheffer explained.
Belted kingfishers, for example, were entirely absent from the count.
The data also found no northern mockingbirds or gray catbirds. Several groups noticed an abundance of the dark-eyed junco, though Sheffer noted that the reasons for these changes from previous years are as of yet unclear.
However murky the causes, Sheffer noted that the amassing of this data lays the foundation for vital observations surrounding species trends. Citizen science observations enabled scientists to discover that the range of the northern cardinal was expanding, for example, and that the Cooper’s Hawk is becoming more common in the wintertime New England forest as it’s been staying behind to prey on smaller songbirds that congregate at bird feeders when the ground is snow-covered.
Sheffer noted, though, that it’s not all about the data.
“The history of the Christmas Bird Count is really moving,” she said, explaining that its origins lie in a Victorian tradition of a Christmas “hunt,” where groups would scour the hillsides and treetops to kill, not count.
Since ornithologist Frank M. Chapman declared the first count in 1900 as a direct opposition to the hunt, the tradition has stuck. Sheffer said it’s a valuable example of how humans’ relationship to the natural world can be reframed.
"It’s important for us now more than ever to be serving birds” as stewards, she said, noting that many species face threats due to climate change and habitat degradation and loss. And another plus, Sheffer said, is the spirit of community, bringing people of all experience levels with birds together for what she described as a truly joyous day: “It’s become an event that brings people together in a really moving way.”
The Trixie Strauss count is just one of 20 in Connecticut. Several, including one just over the border in Pawling, New York, have yet to occur. For a list of each upcoming count, and who to contact with inquiries, visit ctbirding.org/cbc-2025-2026/.
John and Diane Degnan plan to convert the warehouse at the back of the property into their primary residence, while leaving the four-unit building in the front available for long-term rentals.
KENT — A proposal to convert an old warehouse into a residence on Lane Street in downtown Kent has become more complicated than anticipated, as the Planning and Zoning Commission considers potential unintended consequences of the plan, including a proposed amendment to Village Residential zoning regulations.
During a special meeting Wednesday, Dec. 10, attorney Jay Klein of Carmody, Torrance, Sandak and Hennessey presented the proposal on behalf of John and Diane Degnan, who have lived at 13 Lane St. since 2022.
The Degnans are seeking to convert an industrial structure at the rear of their property, currently used for storage, into their primary residence, while keeping a four-unit building at the front of the lot available as affordable rental housing.
What appears to be a straightforward proposal has been complicated by a murky zoning history and regulatory constraints tied to the property’s designation.
Neighbors, however, say the review process has dragged on unnecessarily and are urging the commission to move forward with a project they believe would benefit the street.
“Is it normal for zoning to go this far?” asked Lane Street neighbor Lili Mason during the public comment period at the Dec. 10 meeting. “This is all ridiculous as far as I’m concerned.”
Mason’s frustrations were echoed by other testifiers, who voiced unified support for the Degnans’ project and praised the couple’s character:
“[They’ve] changed the neighborhood for the better,” said Ed Raftery. “Don’t penalize people who are trying to make improvements,” said Tamara Potter, another Lane Street resident, who recalled overpowering shellac fumes drifting through the neighborhood when the warehouse was used to store pleasure boats.
According to Land Use Office records, the structure has previously housed an auto body repair shop, an aquarium store, a mail-order book business, sign production and a skin care mail-order operation, among other uses.
“A commercial building on this street just doesn’t fit,” Potter emphasized, alluding to the fact that the conversion of the warehouse to a residence would essentially prohibit the possibility of a future industrial use on the property.
Commission members largely agreed with residents that the proposal — combining a new residence with affordable rentals — would be a positive change. Several commissioners, however, raised concerns about the applicant’s approach, particularly a proposed amendment to the section of regulations governing special permits in the Village Residential zone.
With guidance from zoning expert Glenn Chalder and town attorney Michael Ziska, the commission pushed back on aspects of the amendment, which would add a new section specifically addressing conversions of industrial or commercial buildings to residences. The proposed language included specialized rules related to density, parking and discretionary waivers of certain zoning requirements.
New commission member Donna Hayes, who was once the town’s land use director, explained that regulations designed for a particular project can have unintended effects elsewhere in town:
“One of the things that [residents] need to understand is that a regulation is written not for a specific piece of property but for a complete zone. And it’s written not for any particular person, but it’s written for the future as well.”
Ziska offered a similar warning: “Once regulations are changed, things happen. Things happen that nobody can expect.”
He expressed doubts about several aspects of the applicant’s proposal, though indicated general support for the concept and suggested there might be a simpler and safer way forward.
Klein said the Degnans’ goal is to improve the property “utilizing existing site resources” while bringing the entire parcel into zoning compliance. Ziska noted that the four-unit building at the front of the lot was never formally approved by a zoning officer — an issue that will need to be resolved if the units are to be used as affordable rentals. Chalder and several commissioners recommended that the applicant work with Kent Affordable Housing in coming up with a plan for the units, which Klein said would be priced between $950 and $1,800.
Klein, Chalder and Ziska ultimately agreed to meet later in the month to come up with a path forward agreeable to both the Degnans and the town. The hearing was left open, and will continue at P&Z’s next regular meeting on Jan. 8.