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Legislative Update July 2001

HB 4 Passes Ohio House , Pharmacy Freedom of Access Legislation Reviewed, Rx Program Introduced

Alyson Welsh, Director of Government Affairs

House Bill 4 Passes The Ohio House of Representatives

House Bill 4, the Governor’s plan to provide discounts to participants in the Golden Buckeye Card program, passed the Ohio House of Representatives on Tuesday, June 5. This bill provides the Ohio Department of Aging the authority to contract out the administration of the long-standing state run Golden Buckeye Card, to an outside entity. This bill has been undergoing many changes, and OPA has been loudly voicing the concerns that pharmacy has with this program. Therefore, although initially we were told no amendments would be accepted, OPA was successful in lobbying for the following amendments to HB 4:

Pharmacy Freedom of Access Legislation Being Reviewed Over Summer Break House

Bill 53, the freedom of access bill for pharmacy, received two hearings in the Ohio House Health & Family Services Committee. HB 53 will allow any pharmacy to participate in a health insurance plan as long as they are willing to accept the same terms and conditions of other participating pharmacies. OPA member Tom Whiston traveled to Columbus to provide testimony to members of the committee about the complaints he receives in his pharmacy related to the provisions contained within HB 53. Tom focused his testimony on the state retirement systems, and how many of patients who are members of STRS and SERS are no longer able to fill their prescriptions at his pharmacy.

Last year the Ohio General Assembly passed a bill that requires any “health mandate” piece of legislation to be sent to a private research company to analyze the cost implications on the business community. Therefore, HB 53 has been officially sent off to Milliman USA for the next 60 days. Milliman will research the implications on business, the health care environment and hopefully the state retirement systems pharmacy benefits programs. When the actuarial study is completed, it will be presented to the Ohio House Health & Family Services Committee.

Labor Unions Rally behind State Senator Robert Hagan and State Representative Dale Miller’s Introduction of Rx Program Bills
HB 290 and SB 127 were unveiled during a press conference at the Statehouse that was attended by both the Ohio Senate and Ohio House of Representatives leaders from the Democratic party, along with labor union and senior citizens representatives. Senator Robert Hagan and State Representative Dale Miller introduced Senate Bill 127 and House Bill 290, respectively. These bills will create the Rx Program within the Ohio Department of Job and Family Services (ODJFS) to provide Ohioans with discounted prescription drugs. Under this plan, manufacturers and wholesalers who sell drugs through a state health plan may enter into a rebate agreement with ODJFS to make rebate payments to the department quarterly.

The pharmacist must discount the prescription drug for a participant of this program. The discount provided by the pharmacist must be the amount of the rebate that the manufacturer or wholesaler pays ODJFS in the rebate agreement. After dispensing the prescription, the pharmacist must then submit a claim to ODJFS verifying the amount they charged the participant. The pharmacist will then be reimbursed by ODJFS the amount of the discount and a professional fee (under the bill it is $3).

Under HB 290, a list of the manufacturers and wholesalers who do not enter into the rebate agreements with ODJFS will be available to the public, and the drugs manufactured by those companies must receive prior authorization by ODJFS before the costs of those drugs will be reimbursed under Medicaid.
OPA has some serious concerns with these bills and will be closely monitoring any progress on these pieces of legislation.

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