Roundup of Legislation in the States
Legislatures Consider Variety of Measures Going in Different Directions
MISSOURI PBM BILL FACES STIFF OPPOSITION FROM EXPRESS SCRIPTS AND OTHER PBMS
Pharmacy firms fight proposed legislation
(Fort Scott Tribune, March 6, 2011) "Power politics have come to the foreground in the 96th General Assembly's review of proposed legislation to change the way medications are prescribed and provided." more
Here is a summary and link to the bill:
[Note - Portions of this act are identical to SB 918 (2010). ] The bill covers several issues including electronic transmission of prescriptions, regulation of pharmacy benefit managers (PBMs) and their relationships with pharmacies, procedures for governing switch communications, informing patients of any cost sharing changes due to proposed switches of medications, and oversight of switch communication by the Department of Insurance, Financial Institutions, and Professional Registration. The act also specifies that a PBM owes a fiduciary duty to a covered entity and shall notify the covered entity in writing of any activity, policy, or practice of the PBM that directly or indirectly presents any conflict of interest. SB 236 also requires PBMs and health carriers to provide a website with a list of medications which require preauthorizations. Portions of this act are identical to SB 918 (2010).
WHILE ON THE OTHER HAND.... MAINE'S GROUNDBREAKING 2003 PBM PRICING DISCLOSURE & CONFLICT OF INTEREST LAW THREATENED WITH REPEAL
Maine's 2003 Pharmacy Benefit Manager law would be repealed if a bill introduced March 15, 2011 is enacted. The legislation,LD 1116, "An Act To Restore Market-based Competition for Pharmacy Benefits Management Services" is sponsored byRepresentative Meredith Strang Burgess and repeals the state's Pharmacy Benefit Manager Transparency Law, 22 MRSA 2699. The law bars conflicts of interest, kickback and self-dealing by PBM drug industry middlemen, and requires the value of rebates to be passed through to ultimately benefit consumers. Te law was amended in 2010 to give the Bureau of Insurance limited oversight authority over PBMs and to require the State Auditor to assist state agencies in contracting with PBMs.
SIX STATES CONSIDER EXTENDING PSYCHOTROPIC PRESCRIBING RIGHTS
Legislators in Arizona, Hawaii, Montana, New Jersey, Oregon and Tennessee are considering bills that would allow psychologists to prescribe psychotropic medications. But the measures are staunchly opposed by the American Medical Association, the American Psychiatric Assn., state physician organizations and others who maintain that the proposals would jeopardize patient safety. more
ON THE OTHER HAND, MAINE CONSIDERS TIGHTENING UP PRESCRIBING OF ANTIPSYCHOTIC MEDS TO KIDS
"An Act To Ensure the Safety of Children in the MaineCare Program Who Are Prescribed Antipsychotic Medications"
has been sponsored by Rep. Joan Welsh. You can read the bill here.
PENNSYLVANIA PHARMACISTS FIGHT MAIL ORDER MANDATES WITH LEGISLATION
WHYY NEWSWORKS, MARCH 7, 2011
"Pharmacists in Pennsylvania are battling against mail-order drug companies this legislative session. They are pushing for a bill in Harrisburg that would prevent insurance companies from requiring patients to get some of their prescription drugs filled via mail order. Pharmacists say customers should have a choice about where they fill their long-term prescriptions, such as medications for high blood pressure." more
NEW YORK PHARMACISTS ALSO TAKE AIM AT MAIL ORDER REQUIREMENTS OF PBMS
Pharmacists Fight the Rise of Mail Order
NY Times, By REED ABELSON and NATASHA SINGER
(March 3, 2011): "A fierce battle is being waged between retail pharmacists and mail-order companies over where people should be able to fill their long-term prescriptions. Community pharmacists in New York are lobbying state lawmakers to pass legislation that would prevent health plans from requiring patients taking medications for chronic ailments to fill their prescriptions through the mail... The proposed legislation, which was introduced in both state chambers in late February, would ban mandatory mail-order programs." more
WHILE BILLS IN MAINE WOULD REPEAL THE STATE'S GIFT DISCLOSURE LAW AND ACADEMIC DETAILING LAWS, OHIO, NEW YORK & ALASKA LEGISLATORS SEEK TO BEEF UP REPORTING BY DRUG COMPANIES
In Maine, pending legislation would repeal that state's current law requiring disclosure of gifts and marketing expenditures by drug companies a time when some Maine legislators are seeking to repeal Maine's gift disclosure law. The bill, LD 719, also repeals funding for academic detailing, reporting on clinical trials, and key price disclosure requirements that have helped the state become a national leader in negotiating steep rebates with the drug manufacturers. It isn't clear if this is simply a pharmaceutical industry bill or if the initiative is supported by the new Republican majority in the Legislature. Governor Lepage's budget also would repeal the groundbreaking MaineRx discount drug program, which PhRMA litigated all the way to the US Supreme Court (and lost).
At the same time, Ohio legislators are looking to beef up reporting in that state. Read more about the Ohio legislation here: Ohio Moves to Make Drug Companies Report Payments to Doctors; ProPublica, by Marian Wang, March 2, 2011: "Health care professionals in Ohio have received more than $13 million in payments from eight drug companies since 2009, according to our database. Now, a bill could require all companies to report these payments directly to the state."
New York also has pending legislation to require pharmaceutical companies that market prescription drugs in the state to report marketing costs annually. Senate Bill 2855 is similar to laws in the District of Columbia (§48-833.01) and the Maine law threatened with repeal (22 §2698-A) and would require the reporting of specified payments in excess of $75.00. In addition, SB 2855 seeks to eliminate the deduction of advertising expenses for purposes of determining "net income" under the New York Franchise Tax law for business corporations. more
Alaska Rep. David Guttenberg, a NLARx member, has introduced a comprehensive package of bills designed to reduce drug costs, including marketing disclosure:
· HB 42 addresses discount regulations by placing requirements on pharmacies and the Department of Health and Social Services.
· HB 43 requires the use of generic drugs when appropriate to lower costs.
· HB 44 establishes a prescription drug card program for discounts and allows the State to negotiate drug prices.
· HB 45 allows for savings through reporting of marketing costs.
· HB 46 establishes an Alaska Prescription Drug Task Force whose mission is to make recommendations on how to lower costs.
· HB 47 allows for public access to a database of clinical trials performed in Alaska. more info
NEW YORK GOVERNOR PROPOSES BIG CUTS IN EPIC, THE STATE PRESCRIPTION DRUG PROGRAM FOR THE ELDERLY
Gov. Cuomo has proposed cuts in EPIC, the New York prescription drug program for people age 65 and over. EPIC would no longer cover anyone who does not also participate in Part D. Of the current 307,700 enrollees, about 52,969 are not in Part D plans - (8/2009 figures) because they are in Medicare Advantage, a retiree plan, or not eligible for Medicare (immigrants without green cards for 5 years). As a result, 17% of current EPIC members would no longer be eligible for EPIC. In addition, EPIC would no longer cover drugs during the annual deductible period (21 out of 33 Part D plans in NYS in 2011 have an annual deductible). EPIC would no longer “wrap around” Part D to help reduce its costs. 52,000 (out of 302,000) enrollees who are not on Medicare or who have Medicare but have been excused from enrolling in Part D because it would jeopardize their retiree coverage, etc. In the end of 2009, out of 254,000 EPIC members with Part D, about 77,800 had “Extra Help” or the Low Income Subsidy, or fewer than one-third of those who have Medicare.
