Oct. Legislative Update: Golden Buckeye Rx Drug Card Update
New Legislation: Any Willing Pharmacy & Pharmaceutical Manf. Disclosure billsLegislative Update October 2003
Kelly Vyzral, Director of Government Affairs
Fall is upon us and that signals the return of the legislature. As the legislative session heats up, we look forward to working toward the passage of several pieces of important pharmacy related legislation. We expect to hear sponsor testimony on SB 43, the Uniform Prescription Drug Card bill. We will also be working on HB 146, the Diabetes Coverage bill; and HB 142, the Meningitis legislation that passed the House in June and was assigned to the Senate Health Committee. We will also be closely watching two companion bills that would create prescription drug programs: SB 14, the Prescription Pricing bill introduced by Sen. Bob Hagan; and HB 166, introduced by Rep. Dale Miller.
Golden Buckeye Prescription Drug Card Update
Governor Taft held a kickoff for the Golden Buckeye discount drug card program on Monday, September 22. OPA still views this program as a form of government price control, and will continue to object to such programs in the legislature. However, there are a few positive notes in this program. First, this is the only program in the country to force the PBM to totally disclose any rebates paid to it, and to share these rebates with the public. Remember that the program is financed by the PBM receiving 50 percent of the rebate, and the public receiving 45 percent of the rebate. The second unique feature of this program is that your pharmacy will receive 5 percent of the rebate as reimbursement for your time in dealing with the rebate. This payment required federal approval, and is unique in the United States. At least this program is recognizing that you have costs associated with processing and dealing with these rebates.
The BEST news in the Golden Buckeye program is that they have placed a number of the income-qualified programs of the Together Rx card into this program. In other words, those individuals who fall below a certain income level will be qualified to obtain the very low prices offered under some manufacturers’ indigent drug programs. The good news for you is that the drug reimbursement under these programs is about AWP minus 6 percent, which makes the program somewhat liveable for those drugs covered. You should begin seeing these new Golden Buckeye cards soon. If you need technical information, or want to sign up for the program, call Scott Luther at Member Health at 888.868.5854 ext. 110.
Two new pieces of legislation sure to stir up interest in the legislature are HB 253, the Any Willing Pharmacy bill, which was introduced in July of 2003 and would allow any pharmacy to participate in any insurance program. OPA strongly supports this legislation introduced by Representative Tom Patton, a Republican from Strongsville. SB 123, the Pharmaceutical Manufacturers Disclosure bill, was introduced by Sen. Robert Hagan, and would require pharmaceutical manufacturers to disclose their advertising and promotional expenses to the State Board of Pharmacy, and to require the Board to compile the disclosures into an annual report. OPA will continue to monitor these bills and update you on their progress through the legislature.
The Department of Human Services
The Department of Human Services recently filed a rule concerning co-payments for non-PDL drugs. The department will impose a $3 co-payment for prescription medications not found on the department’s PDL list. The rule also prohibits providers from denying medication to consumers due to the inability to pay the cost-sharing amount. Consumers who are unable to pay their co-payment may declare their inability to pay and obtain their medication without paying their cost-sharing amount. The consumer remains liable for the co-payment, and the provider may bill the consumer for the co-payment or may request payment for a prior uncollected co-payment. However, the consumer may not be denied subsequent services based on his/her failure to pay an outstanding co-payment.
A public hearing for this rule proposal was held September 16, and OPA strongly objected to the rule that denies you the right to refuse service if the patient does not pay their copay. OPA will work for the introduction of legislation to allow you to deny service if copays are unpaid. OPA also objected to copays in general, but recognize that these copays will be on a small number of drugs.
Proposed Compounding Legislation
OPA was recently approached to support proposed legislation that would allow a pharmacist to compound and dispense a dangerous drug to a licensed prescriber for use by the prescriber in the prescriber’s office. This legislation would allow for non-patient specific, multi-dose compounding. It would place strict guidelines on the disposal of sterile injectables, and a 60-day expiration on other compounds. If anyone with specific expertise or interest in the area of compounding is interested in reading the proposed legislation and commenting, please contact Kelly Vyzral, Director of Government Affairs, at email@example.com
or 614.798.0037 by the end of October.