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2003 LEGISLATION BY STATE
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State Bill |
Description / excerpts of bill text |
Code |
|
Would regulate pharmaceutical benefit managers and other entities that are payers of any type of medical claims must pay claims within certain time periods. |
PBM |
|
|
Would allow correctional facilities and jails to transfer unused prescription medication to charitable clinics. |
Re |
|
|
AL |
Would create a preferred drug list in Medicaid. |
M, PDL |
|
AL |
Would authorize the Alabama Medicaid Agency to enter into arrangements to require manufacturers of generic drugs prescribed to Medicaid recipients to provide rebates of a specified percentage of the average manufacturer price for the manufacturer’s generic products. |
M |
|
AL |
Would require a physician prescribing a medication to prescribe a generic equivalent if available unless the physician notes in the patient’s record that the brand name is medically necessary and notes on the prescription to the pharmacist that the brand name medication is medically necessary. |
- |
|
AK |
Would create a uniform health insurance and prescription drug information card. |
- |
|
AZ |
Gov. Janet Napolitano signed an executive order setting in motion a new program to allow Medicare-eligible seniors to purchase prescription drugs at lower prices through contracts to be administered by Arizona’s Health Care Cost Containment System (AHCCCS.) |
D |
|
AR |
Would regulate and license pharmacy benefit managers. |
PBM |
|
CA |
Would expand the Healthy Families Program to provide medical and pharmaceutical coverage to employed childless adults who are uninsured for health care coverage and who meet certain household income requirements, subject to approval of a federal waiver and appropriation of state matching funds. Under existing law, the Healthy Families Program becomes inoperative on January 1, 2004. |
M, P+ |
|
CO |
Would require providers of pharmaceutical services to reimburse the department of health care policy and financing for the cost of medications that the department has paid to the provide that are returned by health care providers, if those medications are available to be dispensed to another person. |
Re |
|
CO |
Would allow a tax credit for seniors for pharmaceutical expenses. |
S |
|
CO |
Would create a program to provide assistance with prescription drug costs to senior citizens using moneys received under the tobacco master settlement agreement. Would also allow additional rebates from manufacturers. |
S |
|
CO |
Would designate an entity to create a prescription drug purchasing pool and make prescription drugs available to certain low-income people at a discounted rate. |
D |
|
CO |
Would create a preferred drug list (formulary) for Medicaid. |
M, PDL |
|
CO |
Would create a waiver program modeled after “Healthy Maine” for people at or below 200 percent of the FPL. Would require a federal waiver which shall only be prepared if the department receives gifts, grants, or donations sufficient to provide for the state’s administrative costs of preparing and submitting the waiver. |
D |
|
CO |
Would establish evidence-based medicine as basis for a preferred drug list and regulation of pharmacy benefit managers. |
M, PDL, D, PBM |
|
CT |
Would increase income eligibility for Connecticut’s Pharmaceutical Assistance Contract to the Elderly and Disabled Program. |
S |
|
CT |
Would allow seniors to deduct the cost of pharmaceuticals to qualify for Connecticut’s Pharmaceutical Assistance Contract to the Elderly and Disabled Program. |
S, D |
|
CT |
Would require the commissioner of Social Services to negotiate supplemental Medicaid rebates from drug companies in an amount equal to or greater than rebates available under existing federal law, and to further negotiate with such drug companies the cost of prescription drugs for uninsured residents, and establish the Affordable Prescription Drug Board. Would protect consumers and improve the functioning of the prescription drug marketplace by increasing information available about prescription drug pricing. |
M, D, |
|
CT |
Would establish a ConnPACE, Part B program to allow more state residents (seniors at or below 400 percent of federal poverty level and other residents at or below 300 percent) access to discounted prescription drug benefits. |
D |
|
CT |
Would allow seniors to deduct cost of pharmaceuticals in order to qualify for ConnPACE. |
S, D |
|
CT |
An FY 03 budget reduction law increases copayments for ConnPACE state subsidy program members from $12 up to $16.25; increases the application fee from $25 to $39; and reduces the dispensing fee to retail pharmacies for ConnPACE (and Medicaid), from $3.85 to $3.60. |
S, M |
|
CT |
Would require the insurance commissioner, in consultation with the Pharmacy Commission, to study pharmacy benefit management (PBM) plans. The study must decide whether further regulation of such plans is required, and if so, the commissioner must indicate the type of regulation needed. |
PBM |
|
CT |
Would require the state join in a purchasing pool with the other New England states for the procurement of prescription drugs and other health care goods and services. |
D, Bulk |
|
CT |
Would provide loans to federally qualified health centers for the cost of establishing a pharmacy facility or a partnership with a community pharmacy to serve as a centralized prescription drug distributor for federally qualified health centers that have established affordable pharmaceutical drug programs for qualified low income patients of such centers. The Commissioner of Social Services would assist any federally qualified health center that is applying for a loan by providing non-individual identifying information concerning potential participants in the affordable pharmaceutical drug program. |
D, 340B |
|
DE |
Would authorize the Health Security Authority to negotiate or establish manufacturer discounts and rebates for covered prescription drugs and other health care products as part of a single payer health care system. |
D |
|
FL |
Would revise the pharmaceutical expense assistance program for low-income elderly individuals, add eligibility groups and provide benefits. |
D |
|
Would enact the Florida Pharmacy Benefit Management Regulation Act to establish standards and criteria for regulation & licensing of pharmacy benefit managers (PBMs). |
PBM |
|
|
FL |
The FY 04 budget would include $16.2 million for expansion of the Silver Lifesaver Rx Program, “that would assist more than 250,000 seniors with their prescription drug costs.” Also requires a 2.5 percent co-insurance for pharmaceuticals from beneficiaries, up to $7.5 limit; also establishes a prescription drug recycling/reuse program in long term care facilities, with estimated savings of $14.1 million. |
S |
|
FL |
Would urge the Congress of the United States to enact legislation repealing all laws prohibiting importation of large quantities of prescription drugs for resale in the United States in order to make such drugs available to the people within the United States at a cost competitive with the costs incurred by the residents of England, Italy, Germany and France. |
D |
|
FL |
Would create “The LifeSaver Rx Program,” that would operate as a |
D |
|
FL |
Would establish Florida Fair Market Drug Pricing Act and the Rx Card program as a state pharmaceutical assistance program to provide discounts to participants for drugs covered by a rebate agreement. It would use funds from negotiated rebates to provide a discount for people who are in the Medicare program or have a net family income at or below 300 percent of the FPL and are without any other adequate prescription drug coverage. |
D |
|
Would create the Sunshine for Seniors Act to assist low-income seniors with obtaining prescription drugs from manufacturers pharmaceutical assistance programs. Appropriates $226,660 for operations. |
CL |
|
|
GA |
Would create a discount program for those aged 55 and over, based on use of voluntary manufacturer rebates, using features of the Maine Rx law. |
D |
|
HI |
Would allow the income eligibility limit for the Medicaid Prescription Drug Expansion Program, created in 2002, to be lower than the original 300 per cent of the federal poverty level. |
M, P+ |
|
Would establish duties and obligations for pharmaceutical benefit management companies that administer or manage prescription drug benefit coverage to their clients. |
PBM |
|
|
IL SB 3 |
Establishes the Senior Citizens and Disabled Persons Prescription Drug Discount Program Act, requiring the state to “negotiate and enter into rebate agreements with drug manufacturers” to effect prescription drug price discounts, with enrollees receiving the resulting discount. Eligible senior citizens and disabled persons are not subject to income maximums, with disabled defined to include those eligible for Social Security disability or “unable to engage in substantial gainful activity.” Those eligible for the state Rx subsidy program also are eligible, for coverage of products not covered by the state subsidy. Requires a $25 annual enrollment fee, which could be lowered. Will reimburse retail pharmacies the average wholesale price minus 12% for brand name drugs, single-source generic drug products, and a dispensing fee of $3.50 for brand-name and $4.25 for all other generic products. The program is permitted to use or establish a preferred drug list. The program has no connection to Medicaid. Effective date is July 1, 2003 |
D, PDL |
|
IL |
Would require the department to establish a Prescription Drug Purchasing Policy Office. The office would determine and implement strategies for best price purchasing practices for state agencies that pay for prescription drugs by direct purchase or by other arrangements. This may include establishing a central state purchasing policy, entering into cooperative agreements with other states or other public or private entities that may enable the state to reduce its prescription drug costs, and establishing any other state agency policies and practices that may enable the state to reduce its costs. |
D, Bulk |
|
IL |
Would implement drug utilization review and address a reduced rate for prescription drugs for Medicare beneficiaries. |
D |
|
IL |
Would affect medical record privacy by adding pharmaceutical companies to the list of entities prohibited from sharing medical information about a patient. |
Mkt |
|
IN |
Would require the lottery commission to establish a $2 instant win game for the benefit of the prescription drug program and require the lottery commission to transfer $1 for each ticket sold to the prescription drug account. |
S |
|
IN |
Would allow the office of Medicaid policy and planning to limit access to prescription drugs for prescription drug program recipients to prevent fraud, abuse, waste, overutilization, and inappropriate utilization. |
M, PDL |
|
IN |
Would require the office of the secretary of family and social services to establish, implement, and maintain a prescription drug purchasing program to negotiate the costs of prescription drugs for the following groups who may participate in the program: (1) a state agency that purchases prescription drugs or that arranges for the payment of the purchase of prescription drugs; (2) a local unit; or (3) a state educational institution. Specifies that if the state personnel department participates in the program, the self-insurance program or contract must provide for payment for prescription drugs purchased through the prescription drug purchasing program. |
Bulk, D |
|
IN |
Would require the drug utilization review board to develop and implement an Internet site to provide to the public comparative information concerning efficacy, use, and cost of prescription drugs. |
D |
|
IN |
Would authorize the office of Medicaid policy and planning in consultation with the drug utilization review board, to develop and implement a preferred drug formulary. It would set out parameters of the preferred drug formulary; and establish the Rx program to provide discounted prescription drug prices to Indiana residents who are: (1) uninsured; (2) underinsured; (3) Medicare recipients; and (4) covered under insured or self-funded employee welfare benefit plans that provide prescription drug benefits. It would allow a drug manufacturer or labeler that sells prescription drugs to voluntarily enter into a rebate agreement with the state department of health that requires rebate payments to be made to the state for the Rx program; authorize the state department to negotiate the amount of the rebate and audit a manufacturer or labeler to assure compliance; and require a retail pharmacy to sell the drugs covered by the Rx program to participants in the Rx program at the discounted price. It would establish: (1) a formula for the state to use in calculating discount prices for drugs covered by the rebate agreement; (2) a procedure for resolving rebate amount discrepancies; and (3) the Rx dedicated fund, consisting of revenue from manufacturers and labelers who pay rebates and appropriations to the fund. |
PDL, M, |
|
IN |
Would modify the Medicaid preferred drug list, by allowing the state to add a drug that has been approved by the Food and Drug Administration to the preferred drug list without prior approval from the drug utilization review board. |
M, PDL |
|
IN |
Would require the secretary of the office of family and social services to use money in the Indiana prescription drug account only for the Hoosier prescription drug program, and automatically allot the money for use in the prescription drug program. |
S |
|
IN |
Would allow the designation of a mail order or an Internet-based pharmacy to provide prescription drugs under Medicaid or other health plans and would prohibit a denial of coverage for a covered prescription drug solely because the prescription drug was obtained from a pharmacy other than a designated mail order or Internet-based pharmacy. |
|
|
IN |
Would require group health coverage programs for public employees, the office of Medicaid policy and planning, accident and sickness insurers, and health maintenance organizations that use a multi-tier copayment policy for prescription drugs to maintain on an Internet web site: (1) a list of the prescription drugs; (2) the tier that applies to each prescription drug and any alternative to the prescription drug that is in the prescription drug category entered by the consumer; (3) the preferred drug in the drug category entered by the consumer; and (4) a definition of “prior authorization” and the policy concerning prior authorization. |
M, PDL |
|
IN |
Distribution of unused drugs. Would allow a pharmacy or pharmacist to donate medications to certain health clinics. Would allow a pharmacist to accept returned medications from a hospice program. |
Re |
|
IA |
Would provide for the establishment of a senior pharmaceutical assistance program; to “provide a comprehensive pharmacy benefits plan for Iowa's Medicare-eligible population.” Eligibility would include residents age 65 or older, with three tiers of benefit and copayments: Those with income up to 160 percent of poverty would have no deductible; income between 160 and 240 percent would be responsible for a deductible of $500 per year; and income over 240 percent would be responsible for a deductible of $1,000 per year. All enrollees would pay a $20 annual enrollment fee, and copayments of $5 for generics and $20 for brand-name drugs. To “ensure appropriate use of pharmaceuticals, the program shall reimburse pharmacists for medication therapy management services.” Medicaid provider pharmacies would be required to participate, and provide program discounts to all enrollees. Fees and rebates would be appropriated for operation of the program. |
D, S |
|
IA |
This law, signed by the governor on 4/28/03, establishes a multi-agency bulk purchasing council, preferred drug list, increased co-pays and other changes in pharmacy reimbursements for Medicaid. |
Bulk, M, PDL |
|
Would create the uniform prescription drug information card, to be used by all health benefit plans for all enrollees, beginning at the effective date July 1, 2003. |
- |
|
|
KS |
Would establish the Kansas prescription drug card program as a state pharmaceutical assistance program under Medicaid, using some features of the Healthy Maine program. It would “provide discounts” to participants for drugs covered by a (voluntary) rebate agreement. Using sums from negotiated rebates, the department shall contract with participating retail pharmacies to deliver discounted prices to participants, with eligibility defined as Medicare enrollees or others with income of not more than 300 percent of federal poverty. The discounts received by participants shall be calculated by the secretary on a quarterly basis, but must “approximately equal” the negotiated rebate, minus administrative costs. Would require federal waiver approval. Also would establish standards for a Medicaid preferred drug list. |
D |
|
KS |
Would require the registration of pharmacy benefits management (PBM) companies, including a $500 application fee, a certificate of authority to be renewed annually, and disclosure of financial matters, including “all incentive arrangements or programs such as rates, discounts, disbursements or any other similar financial program or arrangement relating to income or consideration received or negotiated, directly or indirectly, with any pharmaceutical company.” |
PBM |
|
KS |
Would establish a revised “Senior Pharmacy Assistance Program” that “shall provide financial assistance” to eligible individuals for the purchase of prescription drugs. Eligible people would be age 65 or older, with incomes up to 200 percent of federal poverty, consistent with the requirements for federal matching funds. ($17,960 for an individual in 2003). The current program covers people age 67 and older up to 150 percent of federal poverty. The program would be suspended if a federal benefit would cover the enrollees. |
S |
|
KY |
Would provide for the transfer of unused legend drugs, except for controlled substances, from a hospital, nursing home, assisted-living community, or hospice care program to a charitable health care provider. |
Re |
|
KY |
Would require the Cabinet for Health Services to lead a work group to study the possibility of expanding participation in the federal 340B prescription drug discount program and report its findings to the Legislative Research Commission, the Interim Joint Committee on Appropriations and Revenue, and the Interim Joint Committee on Health and Welfare by October 30, 2003. |
D, 340B |
|
KY |
Would require the Department for Medicaid Services to apply for a Medicaid waiver for outpatient prescription drug coverage for seniors and Medicare beneficiaries with incomes that do not exceed 200 percent of the federal poverty level; create the Kentucky Senior Rx Program upon approval of the waiver; establish guidelines for phasing in the program; permit the department to establish enrollment or expenditure caps and cost sharing requirements; establish a Kentucky Senior Rx fund; and require manufacturer rebates and other fees collected in association with the program to be deposited in this fund. |
P+, M, D |
|
LA |
Would require that pharmacy benefit managers (PBMs) be licensed and regulated by the Department of Insurance, including a $500 filing fee. |
PBM |
|
Would create the Louisiana Seniors Pharmacy Assistance Program, including a special fund to assist the elderly and disabled to pay for prescription medications. Eligibility would require enrollees to be age 65 or older, with annual income not more than 100 percent of federal poverty ($8,980 for 2003). Copayment shall be not more than 30 percent of the cost, with maximum annual benefits capped at $1200 and covering only specified maintenance medications. The program may be reduced to conform to available funds; the program would be suspended as of the date a federal subsidy program would begin to serve the affected population. |
P+, S |
|
|
LA |
Would create the Fair Market Pricing Act, with a mandate that the state should expand its “role to negotiate voluntary drug rebates, using these funds to maintain and expand Medicaid services while offering lower drug prices to the uninsured who do not qualify for Medicaid.” Would provide “that the secretary of DHH shall negotiate discount prices” or supplemental Medicaid rebates for prescription drugs from drug manufacturers and labelers, with rebate funds used to establish an “Rx Card Program,” for use by residents either eligible for Medicare, or with income not more than 300 percent of federal poverty. The state could require prior authorization in Medicaid for manufacturers that fail to provide an adequate rebate. The discount card program would be authorized as of January 1, 2004. |
D, M |
|
LA |
Would create the Louisiana Seniors Pharmacy Assistance Program. Eligibility would require enrollees to be age 65 or older, with annual income not more than 100 percent of federal poverty ($8,980 for 2003). Copayment would be not more than 30 percent of the cost, with maximum annual benefits to be set by the agency and legislature at a future date; and covering only specified maintenance medications. The program could be reduced to conform to available funds; the program would be suspended as of the date a federal subsidy program would begin to serve the affected population. |
S |
|
ME |
Would allow certain health care facilities that provide primary and preventive care services to purchase through state agencies or state contracts, prescription drugs and medical supplies for patients to whom they provide free care. |
340 B, |
|
ME |
Would require the state, under certain circumstances, to seek bids for pharmacy benefit management services from a nonprofit pharmacy benefit management entity. |
PBM |
|
ME |
Would require the label and receipt for the purchase of a prescription drug to disclose the full retail price of the prescription and the cost of any payment required of the patient and any third-party payor. |
Lab |
|
ME |
Would provide funding to allow the state to continue to pay its share of the budget to participate as a member in the National Legislative Association on Prescription Drug Pricing for fiscal years 2003-04 and 2004-05. |
D |
|
ME |
Would require prescription drug manufacturers and labelers whose drugs are dispensed to Maine residents to file annual reports with the Maine Health Data Organization regarding their expenses for advertising and promoting their drugs. |
Mkt |
|
Would require a manufacturer or labeler of prescription drugs dispensed in this state that employs, directs or utilizes marketing representatives in this state shall report marketing costs for prescription drugs in this state. Would also require prescription drug manufacturers and labelers whose drugs are dispensed to residents to file annual reports with the department of Human Services regarding their expenses for marketing their drugs and would require that manufactures be fined for failure to report. |
Mkt |
|
|
ME |
Would require a pharmacist to fill a prescription with a generic and therapeutic equivalent to the drug if the prescribing physician does not specify that a particular brand name drug be dispensed. |
- |
|
ME |
Would regulate the practices of pharmacy benefit mangers (PBMs) to ensure full disclosure of contracted activities including contractual financial terms that apply between a pharmacy benefit manger and a drug manufacturer. It also would require that benefits of special drug pricing deals negotiated by these companies would be passed through to consumers and not simply used to as company profits. It also clarifies that violations of law regarding these issues are violations of the Maine Unfair Trade Practices Act and are enforceable by private action or the attorney general. |
PBM |
|
ME |
Requires the Department of Human Services to study and report to the Joint Standing Committee on Health and Human Services the benefits that could be recognized by the state through prescription drug discount programs available under Section 340B of the federal Public Health Services Act used to provide prescription drugs in Maine. |
D, |
|
ME |
Would revise the dates in the Maine Rx law to reflect the delay in implementation due to the federal court challenge. Discounts would begin April 1, 2004, with rebate agreements to be effective January 1, 2005. |
D |
|
ME |
Establishes Maine Rx Plus, which would supplant the original Maine Rx law of 2000, to provide discounts to people with incomes up to 350 percent of the federal poverty level. ($31,430 for an individual, $42,420 for a family of two). Eligibility is extended to residents with unreimbursed prescription expenses totaling 5 percent or more of family income, or medical expenses of 15 percent or more. The 275,000 estimated eligible will include all of the 225,000 people who were eligible for the Healthy Maine Prescriptions Program. Eligible persons will get discounts estimated at 15 percent to 60 percent on those drugs that are on the "preferred drug list" that the state is preparing for the Medicaid program. For products not covered by manufacturer rebate agreements, the state "shall impose prior authorization" in Medicaid "to the extent the department determines it is appropriate to do so" consistent with program goals and requirements of federal law. |
D, M, PDL |
|
ME |
Resolution declares January 22nd as a Maine Rx Program Day and reaffirms support for the Maine Rx Program. |
D |
|
ME |
Resolution calls on GlaxoSmithKline and other drug manufacturers to stop the boycott of furnishing drugs to Canadian pharmacies that fill prescription drugs for U.S. citizens. |
D |
|
MD |
Changes eligibility for participation in the Maryland Pharmacy Assistance Program, setting maximum income at 116 percent of federal poverty guidelines ($10,417 for an individual) and maximum assets at the same level as Medicare QMB enrollees. |
S |
|
Extends the termination date of the Maryland Medbank Program administered by the Maryland Health Care Foundation, through 2006; authorize program funds to be used to distribute medication to enrollees; and require the governor to include in the annual budget bill an appropriation of at least $3,000,000 to the Department of Health and Mental Hygiene for transfer to the Maryland Health Care Foundation for the purpose of making grants to entities to operate the program. |
CL |
|
|
Repeals the former 30,000 limit on enrollees in the 2001 Short-Term Pharmacy Assistance Plan. It has been renamed the Senior Prescription Drug Program. |
S |
|
|
MD |
Would require an employee of a pharmacy or a pharmacist to advise consumers of generically equivalent drugs; and require an employee of a pharmacy or a pharmacist to advise consumers of the cost difference of generically equivalent drugs as compared to brand name drugs. |
- |
|
MD |
Alters the responsibilities of the Health Services Cost Review Commission with respect to funding for the Maryland Health Insurance Plan. Specifies that rebates and discounts obtained by plan administrators shall go to the state program. |
S |
|
MD |
Would authorize the Department of Health and Mental Hygiene to establish a specified preferred drug list; would require the department to implement specified benefits to offset Medicaid expenditures; would establish the State Pharmacy and Therapeutics Committee within the department for the purpose of developing a specified preferred drug list; would require the department to implement specified procedures for prescription drugs that are subject to prior authorization. |
PDL, M |
|
MD |
Would require the Maryland Medbank Program to be administered by the Department of Health and Mental Hygiene and extend the termination date of the Maryland Medbank Program. |
CL |
|
MA |
Would exempt elders and disabled persons in the state’s Prescription Advantage Program from being assessed the new $1.30 per prescription pharmacy user fee, created by a 2002 law. |
S |
|
MA |
Would limit payments to manufacturers by pharmacies, hospitals or other institutions licensed to dispense drugs in the Commonwealth. |
D |
|
MA |
Would establish a pharmacy trust fund to assist in financing the Prescription Advantage Plan. |
S |
|
MA |
The FY 04 budget filed by the Governor (H.1) and the Ways and Means budget (H .4000) would completely eliminate the Prescription Advantage state subsidy program, funded last year at $99 million. |
S, M |
|
MA |
The final FY'04 budget restores funding for the Prescription Advantage subsidy program, at $96.4 million (budget line 9110-1455). |
Bulk, |
|
MA |
Would establish a Mass-Rx discount program, based on required manufacturer rebates, to reduce Rx cost to all qualified residents (based on the Maine Rx program). The names of manufacturers and labelers who do and do not enter into rebate agreements shall be public records. “The department shall impose prior authorization requirements in the Medicaid program under this Title, as permitted by law, for the dispensing of prescription drugs provided by those manufacturers and labelers.” Also would establish “Maximum retail prices for prescription drugs sold in the commonwealth.” |
D |
|
MA |
Would require mail order and internet pharmacies outside of the state to register with the board of pharmacy. |
Mkt |
|
MA |
Would establish a program extending Medicaid discounts on prescription drugs to uninsured citizens. Eligible individuals include Medicare-eligible individuals whose financial eligibility exceeds 188 per cent of federal poverty level and who do not have an insurance policy that covers drugs and other individuals whose financial eligibility does not exceed 300 per cent of the federal poverty level. The division may establish, as part of the discount program, an annual enrollment fee. Subject to appropriation, the division shall make a payment of at least 2 percent of the cost of each prescription or refill dispensed to individuals enrolled in the program. (similar to Healthy Maine) |
D, M |
|
MA |
Would require the division of medical assistance to negotiate supplemental rebates for prescription drugs. |
M |
|
MA |
Would provide that the senate president and speaker each appoint three representatives to National Legislative Association of Prescription Drug Pricing, and a that they provide a “summary of the activities of the association, and any findings and recommendations for making prescription drugs more affordable and accessible to citizens.” |
D, M |
|
MA |
Would require registration and disclosure of pharmaceutical marketing activities and reporting of gifts over $25. Would establish requirements for a prior authorization system. Would allow for supplemental rebates. Would establish a prescription drug waiver and would allow Medicare-eligible individuals below 188 percent of FPL who do not have an insurance policy that covers drugs and other individuals whose financial eligibility does not exceed 300 percent of the federal poverty level who do not have an insurance program that includes a prescription drug benefit, to purchase prescriptions at the Medicaid rate. The state would pay 2 percent of the cost of the prescription. Would establish the Massachusetts Prescription Drug Fair Pricing Program that would, 1) establish a state-wide preferred drug list, 2) use a single purchasing unit, 3) approve the use of bulk purchasing, 4) would approve use of a nonprofit PBM, 5) would allow a discount card program. |
Bulk, D, |
|
MA |
Would allow doctor and pharmacist collaboration for drug therapy treatments. |
- |
|
MA |
Would require that children in the child health insurance program receive prescription drug assistance from the division of medical assistance. |
S, M |
|
MA |
Would regulate the dispensing of complimentary sample or starter dose medication. |
- |
|
MA |
Would require that patients in long-term care facilities be prescribed prescription drugs in single unit doses to reduce wasted medications. Bar code systems would be used to ensure that patients receive the right dosage and medication. Would require a study of the preferred drug list and prior authorization procedure. |
Lab |
|
MA |
Would provide that a condition of a pharmacy’s participation in the Medicaid program, the pharmacy, upon presentation of a valid prescription for the patient and a Medicare identification card, shall charge Medicare beneficiaries a price that does not exceed the MassHealth reimbursement rate, including its dispensing fee. The bill would also allow deductions for medical, dental or other expenses shall include the reasonable costs of travel to Canada for the purpose of purchasing prescription medications for personal use. |
D |
|
MI |
Would create the “Michigan prescription drug fair pricing act,” as a discount prescription drug program for certain individuals; allowing prescription drug manufacturers and labelers to enter into rebate agreements with the department of community health; and would allow certain retail pharmacies to offer certain discounts. |
D, S |
|
MI |
Would require a pharmacist, upon request, to provide the current selling price of a drug dispensed by that pharmacy or comparative current selling prices of generic and brand name drugs dispensed by that pharmacy. The information would be provided to the person making the request before a drug is dispensed to the person. |
- |
|
MI |
Would create the Midwest pharmaceutical compact to provide an enlarged pool for the purchase of pharmaceutical products and services for all Medicaid recipients, publicly insured or uninsured health care recipients, and any other people who the commission deems eligible who reside in the compacting states that are party to this compact. Pharmaceuticals purchased through the compact would be distributed as determined by the commission to Medicaid recipients, publicly insured and uninsured citizens, and any other people deemed eligible who are served by health care professionals, public hospitals and clinics, nonprofit hospitals and clinics, organized emergency departments, or free clinics within each compacting state. |
D, |
|
MI |
Would allow the department to enter into agreements, contracts, or cooperative arrangements to create or join a multistate pharmaceutical purchasing program. The purpose of the agreement, contract, or cooperative arrangement would be to use the collective purchasing power of the participating states and members to reduce the cost of pharmaceutical products and services for those participating states and members. Agreements, contracts, or cooperative arrangements could be executed with any state department, agency, or political subdivision or any other state or with any other person that purchases pharmaceutical products and services. The department would establish a system for the distribution of the pharmaceutical products and services purchased under the pharmaceutical purchasing program to qualified seniors. Each participating state or member of the pharmaceutical purchasing program would provide the pharmaceutical products and services to qualified seniors at its actual cost plus any administrative costs of the pharmaceutical purchasing program, but the administrative costs could not exceed 3 percent of the actual cost. |
D |
|
MN |
Would establish a Healthy Maine style prescription drug discount program for residents with income under 250 percent of the federal poverty level. |
D, S, |
|
MN |
Would establish the senior citizen health benefit fund; modify the use of funds in the medical education endowment and the tobacco prevention and local public health endowment; expanding eligibility for the prescription drug program; and require recommendations for providing prescription drug assistance to senior citizens. |
D, S |
|
MN |
Would establish a “Fair Pricing Act,” extending eligibility to all uninsured residents, and establish additional state only rebates “To the extent that a manufacturer’s prescription drugs are prescribed to a resident of this state, the manufacturer must provide a rebate equal to the rebate provided under the medical assistance program.” |
D, S |
|
MN |
Would require pharmaceutical manufacturers to report AWP pricing on a regular basis to the state. Would also allow supplemental rebate agreements between the state and manufacturers and create a preferred drug list and drug utilization review process. Would establish a coordinated system to access manufacturers’ free drug programs. Would also file a Pharmacy Plus waiver to expand eligibility to 135% of FPL. |
CL, PDL, P+ |
|
MN |
Would authorize the Medicaid agency to administer a supplemental drug rebate program for drugs purchased under the medical assistance program. Also would allow dual-eligible Medicare-Medicaid to receive prescription drug coverage under state law. |
S, M |
|
Would require the CEOs of pharmaceutical manufacturers to personally verify AWP price for Medicaid and report directly to the state. |
M |
|
|
MS |
Would establish standards and criteria for the regulation and licensing of pharmacy benefit managers. |
PBM |
|
MS |
Would enact the “prescription drug fair-pricing act.” It would do the following: establish the prescription drug program within the state department of health to lower prescription drug prices for uninsured and underinsured residents of the state; provide that a drug manufacturer or labeler that sells prescription drugs in the state may voluntarily elect to enter into a rebate agreement with the department; provide that the director of the department shall negotiate the terms of the rebate; provide that if a drug manufacturer or labeler elects not to agree to a rebate, the director may place its products on the prior authorization list for the Medicaid program; provide that the director publicize to health care providers information about the relative costs of drugs produced by those that enter into rebate agreements compared to those that do not enter into rebate agreements; require retail pharmacies to discount the price of prescription drugs sold to participants in the program; provide that all residents of the state be eligible to participate in the program; and require the department to build public awareness of the program and maximize enrollment; direct the state board of pharmacy to adopt rules requiring disclosure by retail pharmacies to program participants of the amount of savings provided as a result of the program. |
D, S |
|
MS |
Would establish under the direction of the state board of pharmacy a drug repository program to accept and dispense prescription drugs donated for the purpose of being dispensed to individuals who meet certain eligibility standards. The program would be developed jointly by the state board of pharmacy, the state department of health and the division of Medicaid. Would provide the criteria for drugs to be accepted and dispensed under the program; and provide certain immunity to participants in the program. |
Re |
|
MS
|
Would establish the “Mississippi Rx Senior Patient Assistance Program” and authorize the division of Medicaid to provide payment assistance for prescription drugs to low-income senior and disabled citizens who are ineligible for drug benefit coverage from public or private sources. It would authorize the division to establish a state rebate program from pharmaceutical manufacturers; authorize a co-payment program; and create a prescription assistance fund. |
S, D |
|
MO |
Would establish the Missouri Rx Card Program as the state pharmaceutical assistance program in the Department of Social Services. It would require the program to provide discounts to eligible participants for drugs covered through a negotiated rebate agreement and require the director to initiate a review to determine whether to place a manufacturer’s or labeler’s products on the prior authorization list for the Medicaid Program. The director could also initiate similar actions involving prior authorizations or formularies for other state-funded or state-operated prescription drug programs. It would allow the director to combine drug pricing negotiations to maximize drug rebates, and grant rule-making authority to the department to implement the program and allow the department to seek waivers to implement the program. |
D, PDL, M |
|
MO |
Under current law pharmaceutical manufacturers participating in the Missouri Senior Rx Program are required to pay a rebate of 15 percent on all drugs. This would set the rebate at 15 percent for brand name drugs and 11 percent for generic drugs. |
S, D |
|
Would establish a prescription drug tax credit for people age 65 and over, providing a 50 percent credit, not to exceed $300 per taxpayer. |
S |
|
|
MT |
Would establish a state subsidized senior prescription drug assistance program; establish a program to match low-income residents who lack prescription drug benefit coverage with prescription drug assistance programs offered by pharmaceutical companies; require the use of generic drugs in the Medicaid program whenever possible; provide for electronically transmitted prescriptions; establish a practitioner-managed prescription drug plan and establish a drug use review board responsible for advising the department on the implementation of the retrospective and prospective drug use review programs. |
S, |
|
MT |
Creates a plan to provide prescription drug discounts to needy seniors over age 62 and not more than 200 percent of the federal poverty level, as a Medicaid expansion. It will also cover people with disabilities over age 18 and those eligible for state mental health services. The program will include a $25 annual fee. Medicaid rebate fund collections may be used to “reimburse participating retail pharmacies for the discount on the average wholesale price of prescription drugs provided to qualified residents.” It is contingent on federal waiver approval. Effective date 7/1/03; expires 6/30/05. |
S, D, M, P+ |
|
MT |
Would establish a senior prescription drug coverage program, termed a “private sector, insurance-based drug benefit.” The program would feature sliding scale premiums to fund a pharmacy-only insurance policy, with 100 percent state-subsidized for those between 75 and 129 percent of federal poverty, to 60 percent subsidy for those up to 199 percent of federal poverty. The state would seek a federal Pharmacy Plus waiver, but could use state funds if needed. The program would serve an estimated 33,900. (One version earmarked $7.5 million in tobacco settlement funds; another would require voter approval for funding and implementation) |
S, P+ |
|
Requests that the federal government control the price of medications in order to make them affordable to everyone. |
D |
|
|
NE |
Would provide for licensure of mail service pharmacies. |
- |
|
NE |
Would require uniform prescription drug cards. |
- |
|
NE |
Would require the Department of Health and Human Services Finance and Support to conduct a prescription drug survey that includes information relating to the acquisition cost of drug products dispensed and costs associated with dispensing drug products, including, but not limited to, overhead, professional services, salaries, and fees. |
study |
|
NE |
Would establish a Cancer Drug Repository program for the return and reuse of cancer pharmaceuticals. |
Re |
|
NV |
Would establish the Office for Consumer Health Assistance to assist consumers in gaining information regarding certain prescription drug programs for consumers without insurance coverage for prescription drugs or pharmaceutical services. |
CL |
|
NV |
Would create the Silver State Commission on Prescription Drugs. |
- |
|
NV |
Would establish a pharmacy therapeutics committee for prescription drugs dispensed by the state. |
M |
|
NV |
Would prohibit Department of Human Resources from taking certain actions to restrict access to prescription drugs for mental illness provided pursuant to Medicaid. |
M |
|
NV |
Would require the Department of Human Resources to establish a program to extend coverage for prescription drugs and pharmaceutical services to people eligible for Medicare who are not eligible for Medicaid and whose incomes are not more than 200 percent of the federally designated poverty level by obtaining a Medicaid waiver. |
P+, S |
|
NV |
Would require using agencies to purchase prescription drugs, pharmaceutical services, or medical supplies and related services only through Purchasing Division of Department of Administration. |
Bulk |
|
NV |
Would establish procedures for reusing certain prescription drugs that are dispensed to, but not used by, a patient in a mental health facility, facility for skilled nursing or facility for intermediate care, or an offender incarcerated in an institution or facility operated by the Department of Corrections. |
Re |
|
NV |
Would prohibit certain acts relating to filling or refilling a prescription via the Internet; would clarify that a person may fill or refill a prescription via the Internet within the time prescribed by law. |
- |
|
NV |
Would require the Department of Human Resources to submit a biennial report to the Legislature concerning the provision of coverage for prescription drugs by a Medicaid fee-for-service program. |
M |
|
NV |
Would establish requirements for the substitution of generics for name brand prescription drugs. |
- |
|
NV |
Would revise the amount of limit on income of senior citizens to qualify for subsidy for prescription drugs or pharmaceutical services from money in Fund for a Healthy Nevada. |
S |
|
NH |
Would establish a prescription drug cost task force. |
- |
|
NH |
Would establish a pharmacy discount program for seniors and disabled persons. |
D |
|
NJ |
Would require pharmacists to print the expiration date of a drug on the container label of a prescription. |
Lab |
|
NJ |
Would prohibit managed care carriers providing prescription drug coverage from requiring covered persons to purchase prescription drugs that are in the form of double-dose tablets or pills. |
- |
|
NJ |
Bill amendment would establish that “any person located outside the United States shall be prohibited from shipping, mailing, distributing or delivering in any manner to any person in this State legend drugs or devices” that are available in the U.S. |
D |
|
NJ |
Would establish the New Jersey Prescription Drug Cost Reduction Study Commission in the Department of Health and Senior Services. The commission would determine ways of easing the impact of increasing prices of prescription drugs on consumers and assess the feasibility of regulating price increases of prescription drugs in the state. |
study |
|
NJ |
Would reduce the minimum age of a person to whom a prescription drug price may be discounted, or a portion thereof rebated, from 62 to 60 years of age. This change will correct an inequity in the current law which prevents New Jersey residents from receiving prescription drug price discounts and rebates at the same age as other states which permit such discounts and rebates for people 60 years of age and older. |
D |
|
NJ |
Would provide a gross income tax credit to assist residents meet prescription drug expenses. The credit would be linked in amount to the prescription drug expenses of the taxpayer and to the income of the taxpayer. Would apply to expenses that exceed 2 percent of the taxpayer's gross income for the year. For married taxpayers filing jointly, as single heads of household or as surviving spouses with incomes for the year of $40,000 or less, the amount of credit is equal to 100 percent of the amount by which the prescription drug costs exceed 2 percent of annual income. Incomes from $40,000 to over $100,000 are allowed a sliding scale from 75 percent to 5 percent of costs. The credit provided by this bill would be applied directly against the taxpayer's tax liability to reduce the amount of tax paid. |
S, Tax |
|
NJ |
Would require prescription drug labels to bear the brand name of prescribed drug as well as name of any generic drug substituted for brand name drug. |
Lab |
|
NJ |
Would permit pharmacists to distribute premiums or rebates in connection with the sale of drugs and medications. |
D |
|
NJ |
Would change the copayment for the state subsidy program (PAAD) to require a $5 copayment for the first two prescriptions purchased during any month, with $2 for each prescription thereafter. Also would require the state to conduct periodic reviews to affirm the residency of persons receiving PAAD benefits. |
S |
|
Would create the New Jersey Rx Program that has features of the Maine Rx law including voluntary manufacturer rebates to achieve discount prices. In implementing the program, the State would act as a pharmacy benefits manager in establishing rebates and discounts on behalf of qualified residents whose income does not exceed 300% of the federal poverty level. |
D |
|
|
NJ |
Would create the “New Jersey Fair Market Drug Pricing Act,” featuring the New Jersey Rx Card Program, to reduce prices to participants for prescription drugs that are covered by a rebate agreement with manufacturers. Eligible enrollees include people qualified for Medicare and others with annual income not more than 300 percent of federal poverty level; the discounts “shall be approximately equal to the amount of the negotiated drug rebate minus administrative costs. Allows the state to impose a prior authorization requirement within state-only and Medicaid Rx programs for products manufactured by any company that “fails to conclude a rebate agreement with the department,” or with discounts not equivalent to those in the state Medicaid program. Effective date July 2004, with discounts to be offered by January 1, 2005. |
D, M, PDL |
|
Would send resolutions to the federal government urging action on various federal Medicare and SSI drug coverage issues. |
S |
|
|
NJ |
Would require that all prescription drug labels clearly indicate whether a drug that is being dispensed to a consumer is a generic product by prominently displaying the words “Generic Drug” on the prescription drug label, or on a separate label that adheres to the drug container, when such a product is being dispensed. |
Lab |
|
NJ |
Would regulate Internet pharmacies and electronic prescriptions. |
D |
|
NJ |
Would direct the state to prepare informational materials for use by the State NJ EASE program and the State Health Insurance Program (SHIP) that provide easily understandable, comprehensive information about what drug assistance is available to senior citizens and disabled persons in the State; provide assistance in applying for State pharmaceutical assistance programs; and – provide information about where and how to apply for federal programs and the pharmaceutical manufacturers’ and commercial discount drug programs. |
CL |
|
NM |
Directs the state to apply for a Pharmacy Plus waiver to establish a state-federal subsidy program for seniors and disabled with incomes up to 185 percent of federal poverty. |
P+, S |
|
NM |
Would require licensing and state regulation of pharmaceutical benefit management companies (PBMs). |
PBM |
|
NY |
Would mandate that the cost of pharmaceutical drugs in NY state be no more expensive than any other location where such drugs could be purchased. Also would establish a “reasonable dispensing fee for dispensing a patented or generic pharmaceutical product to the public.” |
D |
|
NY |
Would enact an interstate compact on equitable pricing of pharmaceutical patented and generic drugs. |
Bulk |
|
Would require expiration dates of Rx drugs dispensed by a pharmacy to be listed on the package for consumers. |
Lab |
|
|
Would establish the “Fair Pricing for Prescription Drugs Act” providing for the establishment and operation of the prescription drug pricing programs, including establishing maximum prices for drugs sold “to any person, partnership or corporation in this state.” |
D |
|
|
NY |
Would lower fees for couples by allowing filing as unmarried individuals under the state Elderly Pharmaceutical Insurance Program (EPIC). |
S |
|
Within the state budget, would establish a Preferred Drug List (PDL) for the Medicaid program. |
M, PDL |
|
|
NY |
Would establish a subsidized Rx insurance policy program for qualified seniors age 65 or older, who could request to receive an annual grant that subsidizes a portion of the cost of insurance for prescription drugs and pharmaceutical services. |
S |
|
NY |
Would authorize the state to seek an 1115 Medicaid waiver for matching federal funds to cover Medicare beneficiaries with income up to 120 percent of federal poverty (QMBs and SLMBs) with full Medicaid prescription drug coverage. (Such individuals currently are eligible for the state-only EPIC subsidy program.) |
P+, |
|
NY |
Would enact the prescription drug discount program providing for discounts to bring down the cost of, and improve access to, prescription drugs. |
D |
|
NY |
Would create a prescription drug discount program for any individual who lacks drug coverage, provider or health plan who chooses to participate, at the reduced cost negotiated by the pharmacy best practices plan. Would create “the Pharmacy Best Practices Plan consisting of: a preferred drug list created by a Pharmacy and Therapeutics Committee, a program of supplemental rebates from drug manufacturers, a prior authorization program to enable consumers to access drugs not found on the preferred drug list, a drug discount program which will permit anyone who chooses to join in the program, an educational outreach component” and a program evaluation. Also would repeal the 2002 mandatory generic substitution law. |
D, M |
|
NY |
Would limit cost sharing responsibilities of participants in the elderly pharmaceutical insurance coverage (EPIC) program. |
S |
|
NY |
Would establish a program for the bulk purchase by the state of all pharmaceuticals used by the state or paid for by the state, to be run by the department of health. Would require that rebates from manufacturers be dedicated to funding the state subsidy program.(EPIC) |
Bulk, D, M |
|
Would provide that retail pharmacies serving as Medicaid providers sell prescription drugs to eligible enrollees at the discounted Medicaid reimbursement rate. (Similar to a 1999 California law.) Eligible participants are defined as “over the age of 60 and not eligible for full Medicaid benefits; and not otherwise covered for prescription drugs under a health benefit plan or public or private prescription drug program.” Effective date would be January 1, 2004. [fiscal note] |
D |
|
|
NC |
Would authorize the state to seek a “Pharmacy Plus” Medicaid waiver to obtain matching funds for seniors between 100 and 200 percent of federal poverty; the waiver “may limit the amount of the prescription drug benefit to not less than $1,500 annually per person covered. The waiver may also provide for co-payments of not more $5.00 per prescription for generic drugs, and not more than $15.00 per prescription for brand-name drugs. |
M, S, P+ |
|
NC |
Would establish a central purchasing entity to provide for bulk purchasing of pharmaceuticals for state agencies. Also would require manufacturers and wholesale distributors of pharmaceuticals in the state to report purchase prices of drugs; also would “provide to business groups, health care service plans, hospitals, hospital associations, and individual consumers the opportunity to participate in a state-administered prescription drug bulk purchasing program.” |
Bulk; D |
|
ND |
Would create a pharmaceutical manufacturers drug access program for low-income individuals. |
CL |
|
OH |
Provides that any record, data, pricing information, or other information regarding a drug rebate agreement or a supplemental drug rebate agreement for the Medicaid program or the Disability Medical Assistance Program shall remain confidential. |
D, M |
|
OH |
Would create the Ohio Rx Program; including manufacturer rebates and discounts for qualified residents; would require the director of Job and Family Services, under specified circumstances, to establish maximum retail prices for prescription drugs; Would make certain violations regarding pricing of prescription drugs a civil offense. |
D |
|
OH |
Non-binding resolution would urge Ohio’s Governor, the leadership of the General Assembly, the Director of Job and Family Services, and the Director of Health to join with a consortium of neighboring states in their efforts to organize a joint nonprofit pharmacy benefit manager to manage their prescription plans for state employees and Medicaid recipients. |
Bulk, D, M |
|
OK |
Provides for reuse of unused prescription drugs at Long Term Care facilities, if sealed in individual, intact packaging for safety, with distribution to the medically indigent at public health facilities. |
Re |
|
OK |
Would create a pharmaceutical assistance subsidy program, for those 65 and over with income limit of not more than 200 percent of federal poverty guidelines. Copayments of not more than $10 required. Would require the state to apply for and “actively pursue” federal waivers. |
S, P+ |
|
OK |
Would create the OK Pharmacy Connection Program as a clearinghouse for information about manufacture free and reduced cost programs. |
CL |
|
OR |
Requires the state to reimburse certain rural health clinics for prescribing and dispensing prescription drugs. Also provides that all health insurance policies that provide a prescription drug benefit, (with limited exceptions) “must include coverage for prescription drugs dispensed by a licensed practitioner at a rural health clinic for an urgent medical condition if there is not a pharmacy within 15 miles of the clinic.” |
- |
|
OR |
Would establish a prescription drug cost comparison program to develop a list of the 25 prescription drugs most frequently used by individuals 65 years of age and older and a cost comparison of those drugs; with a survey to determine prescription drug costs and a list of every licensed pharmacy. Would require the state to compile the results to show the most competitive price to the least competitive price for each prescription drug included in the survey, with results updated quarterly. |
CL, D |
|
OR |
Would direct the Oregon Department of Administrative Services to adopt a preferred drug list for all state agencies that directly or indirectly purchase prescription drugs. Directs Office for Oregon Health Policy and Research to recommend a preferred drug list, to be used with “prior authorization of non-preferred prescription drugs, copayments, drug utilization review, disease management and supplemental rebates from drug manufacturers.” |
M, PDL |
|
Would establish a prescription drug bulk purchasing program for state and other governmental agencies. Directs Health Resources Commission to develop a preferred drug list for use. SB 567 would use a PBM, and establish an independent public corporation. |
Bulk, PDL |
|
|
OR |
Would require licensing and state regulation of pharmaceutical benefit management companies (PBMs). |
PBM |
|
OR |
(As amended) Would state that “If the dispensing pharmacist and prescribing physician believe splitting, breaking or otherwise dividing the prescription medication in pill, tablet or similar form should not be recommended, a health insurer, health maintenance organization, health benefit plan, pharmacy benefits manager, third party administrator or the Department of Human Services may not impose coverage or reimbursement restrictions or penalties.” Permits pharmacists to split pills prior to dispensing. |
Lab |
|
OR |
Would transfer $200,000 in start-up funds from Tobacco Settlement Funds Account to Senior Prescription Drug Assistance Fund. |
D, S |
|
OR |
Would direct the Oregon Department of Administrative Services to adopt a preferred drug list for all state agencies that directly or indirectly purchase prescription drugs. Directs Office for Oregon Health Policy and Research to recommend a preferred drug list. |
S |
|
PA |
Would require that the state administer a single pharmacy benefits manager program for all eligible medical assistance recipients, with a bidding process and a three-year contract. |
PBM, M |
|
PA |
Would increase eligibility in PACENET, to include incomes of $19,100 to $36,000 for individuals and $22,200 to $39,200 for a couple, with sliding scale deductibles and copayments up to $23 per prescription filled. |
S |
|
PA |
Would increase eligibility in PACENET, to include incomes of $17,000 for an individual and $20,200 for a couple. |
S |
|
RI |
Would allows low-income seniors to use Rhode Island Pharmacy Assistance to the Elderly (RIPAE) when private coverage for brand-name drugs runs out. The Department of Elderly Affairs states the legislation will not cost the state any additional funds. |
S |
|
RI |
Would allow Canadian pharmacies to obtain a state license to sell drugs in the state. (federal officials generally had been allowing drugs to be imported as long as they are for personal use and no more than a 90-day supply. The Pharmacy Board opposes the measure on legal grounds; the RI Medical Society supported it.) |
D |
|
RI |
Would create the “RI Fair Market Drug Pricing Act,” using features of the Maine Rx law including voluntary manufacturer rebates to achieve discount prices. Would require the state to “negotiate discount prices or rebates for prescription drugs from drug manufacturers and labelers.” Would provide that a drug manufacturer or labeler that sells prescription drugs in the state “may voluntarily elect to negotiate: (i) supplemental rebates for the Medicaid program over and above those required by federal law; (ii) discount prices or rebates for the Rx card program, which would be established to serve any person eligible for Medicare or with income not more than 350 percent of federal poverty; and (iii) discount prices or rebates for any other state programs that pay for or acquire prescription drugs.” Would allow the option of applying prior authorization for manufacturers that do not provide rebates; also provide for the “public release” of the list of manufacturers not participating. |
D, M |
|
RI |
Would establish price controls on prescription drugs and stipulate that “the maximum price for a prescription drug sold in the state by a manufacturer must be the lower of the price listed in the federal supply schedule for pharmaceuticals and drugs maintained by the federal VA (Veterans Administration) or the price listed in the drug formulary maintained by the Province of Quebec.” Also provides that the state “may enter into agreement with other states in the Northeast and Canadian Provinces for the purpose of maintaining fair and uniform prescription drug prices and insure maximum access to affordable prescription drugs. |
D; |
|
RI |
Would eliminate the state's current ban on the use of manufacturers’ discount or rebate coupons for prescription drugs. The legislation maintains the integrity of existing anti-kickback law; it adds language to allow the use of discount or rebate coupons, which are reimbursed by the manufacturers. |
-, |
|
RI |
Would clarify that no person is eligible for state pharmaceutical assistance unless that person's prescription drug coverage for a specific prescription medication is exhausted during a benefit year or the specific prescription medication is not covered by a plan. |
S |
|
SC |
Would establish Medication Assistance to Seniors (MATS) program within Aging Division of Health and Human Services Department; provisions to assist low income seniors with cost of prescription drug |
S |
|
SC |
Would create a state discount program by requiring a pharmacist to charge only the Medicaid prescription rates, plus a dispensing fee, when filling prescriptions for persons receiving Medicare benefits, based on the California discount program. |
D |
|
Creates the Interstate Bulk Prescription Drug Program with neighboring states to provide prescription drugs at a reduced cost to senior and disabled residents who do not have prescription drug coverage. The program is not specifically connected with Medicaid. |
Bulk |
|
|
SD |
Establishes a senior citizen prescription drug benefit program, “to negotiate the purchase of prescription drugs to be offered at a reduced cost to the eligible participants.” The program will be open to any resident age 65 and older and any person meeting the eligibility criteria for a disability. It will be run by the Bureau of Personnel, which “may enter into agreements with private entities and cooperate with other local, state, or federal agencies to implement the purposes of the program.” It requires rules “regarding various discounts on the purchase of pharmaceuticals for participating members and regarding dispensing and intervention fees.” The program is authorized to create a preferred drug list “for the benefit of participating members and pharmacies.” The program would sunset July 1, 2005 unless continued. |
D, |
|
SD |
Would provide that “no manufacturer may sell drugs to any wholesaler or purchaser in this state on less favorable terms and conditions than those contemporaneously accorded to the manufacturer's most favored wholesaler, purchaser, or consumer in the state, including any transaction in which a manufacturer sells to a purchaser though a contractual arrangement implemented by one or more wholesalers”. |
D |
|
TN |
Would create the “Tennessee Fair Market Drug Pricing Act of 2003,” using features from the Maine Rx law, requiring the state to “negotiate discount prices or rebates for prescription drugs from drug manufacturers and labelers. A drug manufacturer or labeler that sells prescription drugs in this state may voluntarily elect to negotiate: (a) supplemental rebates for the Medicaid program over and above those required by federal law, (b) discount prices or rebates for the Rx Card program, and (c) discount prices or rebates for any other state program that pays for or acquires prescription drugs.” Would also include expanded use of prior authorization. The fiscal note estimates that 500,000 people could use the program, with transactions valued at $200 million. |
D, M, PDL |
|
Provides for establishment of a “TennCare Rx program prescription benefit to individuals lacking prescription drug insurance coverage who meet criteria established by the bureau of TennCare and the general assembly in its annual appropriation,” It is designed to serve a non-Medicaid population, with further details not specified. The new program “may implement tiered co-payments and prior authorization and step therapy requirements” for the program based on the state preferred drug list (PDL). |
S, |
|
|
TN |
Would authorize TennCare bureau to administer pharmacy element to increase rebates, to limit reimbursement for multisource generics in certain circumstances and require maximum allowable cost list and new pharmacy committee. |
M, PDL |
|
Would establish a pharmaceutical discount program, using features from the Maine Rx law. Would include voluntary manufacturer rebates through “an agreement to provide: (1) supplemental rebates for prescription drugs provided under the Medicaid program in excess of the (federal) rebates (2) discount prices for prescription drugs provided under the state pharmaceutical assistance program established, with eligibility by seniors lacking coverage and others to be determined by a commission, and (3) discount prices for prescription drugs provided by any other publicly funded entity.” Would require use of prior authorization for products by manufacturers that do not participate with rebates or discounts. The assistance program would be established by January 2005. |
D, M |
|
|
TX |
Would require the state Department on Aging to provide low-cost transportation for seniors to the U.S.-Mexico border so they could buy lower-cost prescription drugs. Would allow the department to charge fees for transportation, which could be provided through a contract with a commercial bus company. Texas seniors could use the service to travel to Mexican pharmacies and bring back prescription drugs for which they have valid prescriptions. [news story] |
D |
|
TX |
Provides that the state “shall negotiate” with manufacturers and labelers to obtain supplemental rebates for prescription drugs provided under Medicaid CHIP, and any other state program administered by the commission or a health and human services agency, including community mental health centers and state mental health hospitals. Allows for contract with a benefits manager (PBM). (in §2.11). |
340B, D, M, Re |
|
TX |
Would require a Medicaid preferred drug list and supplemental rebates. Would allow use of prior authorization; also would provide that “in developing its recommendations for the preferred drug list, the committee shall consider the clinical efficacy, safety, and cost-effectiveness of a product.” |
M, |
|
UT |
(As passed) Authorizes the department to study a Medicaid drug program. It requires legislative oversight before a Medicaid drug program is implemented. The act clarifies that the department must implement the state Medicaid program through the administrative rule process and must submit a proposed administrative rule that would modify Medicaid benefits, services, or reimbursement methodologies to a Legislative Committee before adopting the rule. |
M, PDL |
|
VT |
Non-binding joint resolution urges GlaxoSmithKline corporation to “immediately resume prescription drug deliveries to Canadian-based mail-order pharmacies.” |
D |
|
VT |
Would require health insurers to cover prescription drugs purchased from pharmacies located outside the United States, on the same terms and conditions as those purchased in this country. |
D |
|
VT |
Would create the Vermont prescription drug fair pricing program, which includes manufacturer rebates, discount prices for those lacking prescription coverage, and future price controls on retail sales. |
D |
|
VT |
Would create a pilot program through which unused prescriptions from nursing facilities could be made available through pharmacies for people who are medically indigent. |
Re |
|
VT |
Would direct that retail pharmacists implement therapeutic substitution of lower cost prescription drugs in place of higher cost brand-name drugs if the prescriber has authorized the therapeutic substitution. |
D |
|
VT |
Would require pharmacy benefit managers (PBMs) to be licensed by the state, and “discharge their obligations to health benefit plans and the beneficiaries of health benefit plans in accordance with standards of conduct established by law.” |
PBM |
|
VT |
The FY 2004 budget provides that the state is authorized to amend the rules for the VHAP-Rx, VScript and VScript expanded to eliminate deductibles and co-payments for any drug. The pharmacy best practices and cost control program (including preferred drug list) shall govern these programs; the department “shall establish monthly premiums” for VHAP-Rx ($13 per month); VScript programs ($17 per month); VScript Expanded program ($35 per month.) |
S, M, PDL |
|
Establishes a state Rx fund to accept appropriations, donations, grants, and in-kind contributions “to develop and implement programs that will enhance current prescription programs.” |
S, CL |
|
|
VA |
FY 03-04 Budget (§ZZ) requires state to implement a Medicaid preferred drug list by January 1, 2004 and reduce the dispensing fee paid to pharmacists from $4.25 to $3.75 per prescription per month. States that other state agencies should “consider utilizing a Preferred Drug List program for non-Medicaid clients.” (§AAA) requires an increase in copayments for brand name drugs to $3. |
PDL, M |
|
Would establish the Virginia Prescription Drug Payment Assistance Plan, modeled on Delaware’s Prescription Drug Payment Assistance Program, to assist eligible elderly and disabled Virginians in paying for prescription drugs. The benefit would be limited to prescription drugs manufactured by pharmaceutical companies that agree to provide manufacturer rebates. Eligible people must have incomes at or below 150 percent of the federal poverty level or have prescription drug expenses that exceed 40 percent of annual income. Administrative costs are to be paid from the pharmaceutical manufacturer rebates to the extent available and the $20 annual enrollment fees. |
D |
|
|
VA |
Would establish the Virginia Insurance Plan for Seniors “to provide assistance in the purchase of prescription drugs for those persons who are dually eligible for Medicaid and Medicare but who do not qualify for prescription assistance.” Maximum assistance would be $80 per month per eligible person, but unused amounts could be rolled over. |
S |
|
VA |
Would establish a joint subcommittee to study the feasibility of strengthening the state’s pharmacy purchasing ability for state programs and using savings generated to create and fund a pharmacy benefits program for low-income and uninsured elderly persons. A 15-member group would be required to compiled a report to the legislature for 2003. |
Study |
|
VA |
Would require, upon implementation of the Medicaid Prior Authorization Advisory Committee or other prior drug authorization mechanism, that (i) if a drug is safe and effective for a medical condition and has been covered for an individual’s medical condition, coverage under the state plan for such drug will not be limited or excluded when prescribed for the covered medical condition of a recipient; (ii) any formulary adopted by the Board must include each therapeutic class in which there are two or more FDA-approved controlled substances and, for each therapeutic class in which there are two or more FDA-approved pharmaceutical or biological agents, must provide coverage of a least two such pharmaceutical or biological agents without an administrative preference for one over the other. |
M |
|
WA |
Would require the state to “develop a comprehensive prescription drug education and utilization system in Washington state that will ensure best prescribing practices and pharmaceutical use, reduce administrative burdens on providers, increase consumer understanding of and compliance with appropriate use of prescription drugs, help to control increases in consumer and state health care spending, and improve prescription drug purchasing through a sound evidence-based process that evaluates the therapeutic value and cost-effectiveness of prescription drugs.” |
D, M |
|
WA |
Would require the state to develop a Medicaid senior prescription drug program “to promote access to affordable prescription drug coverage to low-income persons” age 65 or older with income no more than 200 percent of federal poverty. The state would seek a federal “Pharmacy Plus” waiver. “Consistent with federal waiver conditions, the department is authorized to charge enrollment fees, premiums, or point-of-service cost-sharing to enrollees of the program.” |
M, P+, S |
|
WA |
Would require that a pharmaceutical manufacturer, including generic drug manufacturer, file with the state (1) the average manufacturer price for the requested prescription drug or drugs; and (2) the price that each wholesaler in the state pays the manufacturer to purchase the requested prescription drugs. |
D |
|
WA |
Would establish requirements for state agency contracts with pharmaceutical benefit management companies, including disclosure of any rebate or other agreements between the pharmacy benefit management company and a pharmaceutical manufacturer, its contractors, or an affiliate of a pharmaceutical manufacturer related to the use of that pharmaceutical manufacturer's products. |
PBM |
|
Would establish the Medicaid senior prescription drug program, with eligibility limited to people age 65 and older whose family income does not exceed 200 percent of the federal poverty level and who do not otherwise have insurance that provides prescription drug coverage. References the “state’s federal prescription drug waiver program” and would establish the program as not an entitlement. Also includes a requirement to start bulk-buying among state agencies including uninsured residents and create a preferred-drug list for Medicaid. |
S, P+, M, D, Bulk |
|
|
WA |
Would extend the drug discounts that the state Health Care Authority (which oversees the state’s public and employee health plans) negotiates with drug companies, to people ages 50 and older who have incomes up to 250 percent of the federal poverty level; also would establish a toll-free information clearinghouse, public education sessions and a report on future options. |
D, CL |
|
WA |
Would state that “the Health Care Authority must implement a program to aggregate the purchase of prescription drugs from suppliers for prescription drug programs in this state, to be known as the “aggregate purchasing prescription drug discount program.” |
Bulk |
|
WA |
Authorizes state agencies to develop and use a preferred drug list created by a committee of medical professionals, termed an “evidence-based prescription drug program.” The program may include a preferred drug list, to which agencies must provide reasonable exceptions, based on individual physicians’ decisions. |
Bulk, |
|
WA |
Non-binding resolution urging the US Congress to repeal the federal OBRA '90 and 340B drug pricing provisions, and “and pass new laws which separate the cost of a prescription drug from the delivery of service, thus letting the free market work.” |
D |
|
WV |
Would establish the senior citizens prescription drug subsidy program, designed to provide a subsidy for prescription medications purchased by eligible citizens over the age of sixty-five. Eligibility and benefit design would be established by executive bureau regulations. Funding would be based on voluntary donations through a state tax check-off of up to $10 per taxpayer. |
S |
|
WV |
Would provide for the payment of prescription drug services for senior citizens “who are unable to pay the full cost of prescription drug services”, using funds from the existing “public assistance medical services fund” currently used for welfare recipient services. |
S |
|
WV |
Would require the state to apply for a Medicaid waiver to allow qualified Medicare beneficiary (QMBs) or specified low-income Medicare beneficiary (SLMBs) to be eligible for prescription drug-only coverage, reimbursed with Medicaid matching funds. |
M, P+, S |
|
WV |
Would establish the “WV Prescription Drug Fair Pricing Act,” using features from the Maine Rx law, including manufacturer rebates and discounted prices based on the Medicaid price. “All residents of the state are eligible to participate in the Rx program. The department shall establish simplified procedures for issuing Rx program enrollment cards to eligible residents.” Requires participating retail pharmacies (including Medicaid providers and other voluntary participants) to offer prescription drugs at or below the average wholesale price, minus six percent, plus a dispensing fee not less than Medicaid. |
D, M |
|
WV |
Would establish a WV discount program using features from the Maine Rx law, including manufacturer rebates and discounted prices based on the Medicaid price, available to residents lacking prescription coverage. |
D, M |
|
WV |
Would authorize a preferred drug list under Medicaid. Would require that any “patient who is stabilized on a prescription drug medication previously prescribed by a health care provider, and used by the patient for the treatment of a particular indication, is exempted from any requirements related, directly or indirectly, to the preferred drug list.” |
M, PDL |
|
WV |
Would establish a prescription drug price assistance project. |
S |
|
WI |
2003 Budget bill would affect: Prescription drug cost controls and drug purchasing agreements [§1393]; drug assistance for elderly persons: deductible increase; payment rate to pharmacies reduced. [§1438-1446] |
D, M, S |
|
WI |
Would permit prescription drugs returned to state prison pharmacies to be re-dispensed by the state to other inmates. (The Pharmacy Examining Board currently has a rule allowing controlled return of health items from an “inpatient health care facility” as a hospital, nursing home, county home, county mental hospital, tuberculosis sanatorium, or similar facility.) |
Re |
|
WY |
Would authorize the establishment of a Pharmacy Plus subsidy waiver program, to serve residents with annual income of not more than 175 percent of federal poverty, and assets under $35,000. Provides that, in implementing the Pharmacy Plus program, “the department may use private sector benefit management approaches, including pharmacy benefit managers, preferred drug lists, prior authorization, pharmacist consultation, provider education, disease state management and variable enrollee cost sharing in the form of annual or monthly premium assessments, per prescription copayment requirements, coinsurance, deductibles and coverage limits.” Provides for termination if a federal Medicare benefit is operational. |
S, M, P+, PDL |
|
WY |
Would create the prescription drug consumer information and technical assistance program within the department of health. It includes consultation with professional pharmacist, and evaluation to avoid dangerous drug interactions and substitute more cost effective drugs for the drugs prescribed. |
CL |
|
WY |
Would provide for the licensure and certification of pharmacy benefit management companies (PBMs). Provides terms for revocation of certificate to operate, include financially unable to meet obligations, or for a PBM that “has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner.” |
PBM |
|
WY |
Would require use of uniform pharmaceutical benefit card issued by all insurers, including American National Standards Institute issuer identification number, all policy numbers needed for claims processing, and a help desk telephone number for use by pharmacists. |
- |
* Legislative rules may allow for continuation or “carryover” to 2004 session.
Medicare Resolutions: At least 25 states also considered non-binding resolutions urging the U.S. Congress to enact a federal Medicare pharmaceutical benefit. These include: Alabama, Arkansas, California, Delaware, Florida, Kansas, Kentucky, Maryland, Missouri, Montana, Nebraska, New Jersey, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia and Wyoming.
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