Revision: Jan. 21, 2010, midnight
HB 114 – AS AMENDED BY THE SENATE
30Mar2005… 0864h
04/28/05 1286s
2005 SESSION
10/01
HOUSE BILL 114
AN ACT relative to the regulation of pharmacists and pharmacy technicians by the pharmacy board and establishing the New Hampshire Rx plus program for prescription drugs.
SPONSORS: Rep. Wendelboe, Belk 1
COMMITTEE: Executive Departments and Administration
This bill makes various changes to the regulation by the pharmacy board of pharmacists, pharmacy technicians, and the issuing of prescriptions.
This bill also establishes the New Hampshire Rx plus program for prescription drugs. Under this bill, individuals and families with incomes of not more than 350 percent of the federal poverty level that lack insurance coverage or that have reached the limits of their insurance coverage would be eligible for the program. The bill grants rulemaking authority to the commissioner of the department of health and human services for the purposes of the program.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
30Mar2005… 0864h
04/28/05 1286s
05-0187
10/01
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Five
AN ACT relative to the regulation of pharmacists and pharmacy technicians by the pharmacy board and establishing the New Hampshire Rx plus program for prescription drugs.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Pharmacists; Definition of Dispense. Amend RSA 318:1, V to read as follows:
V. “Dispense” means to distribute, leave with, give away, dispose of, deliver, or sell one or more doses of a drug that will be administered or taken at a later date, time, or location and shall include the transfer of more than a single dose of a medication from one container to another and the labelling or otherwise identifying a container holding more than a single dose of a drug.
2 New Paragraph; Pharmacists; Definition of Distributor Added. Amend RSA 318:1 by inserting after paragraph V the following new paragraph:
V-a. “Distributor” means a person or persons who supply or facilitate the supply of prescription drugs to persons other than consumers.
3 Rulemaking; Pharmacy Technicians. Amend RSA 318:5-a, X(e) and (f) to read as follows:
(e) Establishment of the effective period of registration; [and]
(f) Requirements for renewal of registration; [and]
(g) Requirements for reinstatement of registration; and
4 Rulemaking; Fees for Pharmacy Technicians. Amend RSA 318:5-a, XI to read as follows:
XI. The establishment of fees for registration of pharmacy technicians, including [a fee] fees for renewal or reinstatement of registration.
5 Pharmacists; Disciplinary Action; Registrants, Permittees Added. Amend RSA 318:29 to read as follows:
318:29 Disciplinary Action.
I. The board may undertake disciplinary action against any licensee, permittee, registrant, or certificate holder:
(a) Upon its own initiative; or
(b) Upon written complaint of any person which alleges that a licensee, permittee, registrant, or certificate holder has committed misconduct under paragraph II or V of this section or any other applicable provision of this chapter or RSA 318-B, and which specifies the grounds therefor.
II. Misconduct sufficient to support disciplinary proceedings under this section shall include:
(a) The practice of fraud or deceit in procuring or attempting to procure a license, permit, registration, or certificate to practice under this chapter;
(b) Conviction of a felony or any offense involving moral turpitude;
(c) Any dishonest or unprofessional conduct, or gross or repeated negligent conduct in the practice of pharmacy or in performing activities ancillary to the practice of pharmacy or any particular aspect or specialty thereof;
(d) Behavior which demonstrates a clear conflict with the basic knowledge and competence expected of licensed pharmacists or any particular aspect or specialty of the practice of pharmacy, or any intentional act which demonstrates a clear inconsistency with the health and safety of persons making use of the professional services of any person licensed under this chapter;
(e) Addiction to the use of alcohol or other habit-forming drugs to a degree which renders him or her unfit to practice under this chapter;
(f) Mental or physical incompetency to practice under this chapter; or
(g) Willful or repeated violation of any provision of this chapter, any substantive rule of the board, or any other federal, state, or local drug or pharmacy-related law, rule, or regulation.
(h) [Repealed.]
III. [Repealed.]
IV. The board may take disciplinary action in any one or more of the following ways:
(a) By reprimand;
(b) By suspension, limitation or restriction of a license or probation for any period of time deemed reasonable by the board;
(c) By revocation of license;
(d) By assessing administrative fines in amounts established by the board;
(e) By requiring the person to participate in a program of continuing education in the area or areas in which he or she has been found deficient; or
(f) By requiring the licensee to submit to the care, observation or treatment of a physician, counseling service, health care facility, professional assistance program, or any comparable person or facility approved by the board.
V. The board may, after notice and hearing, suspend or revoke a pharmacy permit or registration for grounds which include, but are not limited to:
(a) The suspension, revocation, or expiration of the pharmacist license of the pharmacist-in-charge.
(b) Termination of the employment of the pharmacist-in-charge with the pharmacy.
(c) Operation of the pharmacy in a manner that is in violation of federal, state, or local drug or pharmacy-related law, rule, or regulation.
(d) Conviction of the pharmacist-in-charge, an owner, a corporate officer, the corporation, or the pharmacy of a felony, a misdemeanor resulting from a violation of any federal, state, or local drug or pharmacy-related law, rule or regulation, or an act involving moral turpitude or gross immorality.
(e) Unsanitary conditions.
(f) Fraud, intentional misrepresentation or perjury in securing the permit or registration or in any hearing before the board.
(g) Unprofessional conduct which includes, but is not limited to, violations of federal, state, or local drug or pharmacy-related laws, rules, or regulations, or other acts or omissions which, in the opinion of the board, pose a threat to the well-being or the safety of the public.
(h) Fee splitting for professional services. This does not prohibit rent payments under a rental or lease agreement for the operation of a pharmacy by a pharmacist or pharmacy to an individual licensed to prescribe medicine.
(i) Any ownership or control of an ownership interest of a pharmacy within the state by an individual licensed to prescribe medicine, or a corporation, professional association or partnership consisting of such prescriber or prescriber’s immediate family members, except such corporations as are expressly exempt from income taxation under section 501(c)(3) of the United States Internal Revenue Code. This shall not include ownership of investment securities purchased by the practitioner on terms available to the general public and which are publicly traded. This subparagraph shall not apply to the ownership or control of an ownership interest of an institutional pharmacy operated within the state by or for hospitals, as defined in RSA 151-C:2, XX, licensed by the state pursuant to RSA 151.
(j) The sale, rental, trade, transfer, or release of patient identifiable medical information for the purpose of sales or marketing of services or products without written authorization.
6 Pharmacists; Denial or Revocation of License; Registrants, Permittees Added. Amend RSA 318:29-b to read as follows:
318:29-b Denial or Revocation of License.
I. Upon receipt of an administratively final order from the licensing authority of another jurisdiction which imposes disciplinary sanctions against a licensee, permittee, registrant, or certificate holder of the board, or a person applying for a license, permit, registration, or certificate, the board may issue an order directing the licensee, permittee, registrant, or applicant to appear and show cause why similar disciplinary sanctions or, in the case of an applicant, why the license, permit, or registration denial or restriction, should not be imposed in [the] this state. In any such proceeding, the decision of the foreign licensing authority may not be collaterally attacked, but the licensee, permittee, registrant, or applicant shall be given the opportunity to demonstrate why a lesser sanction should be imposed.
II. The board may issue any disciplinary sanction or take any action with regard to any pending application pursuant to this section otherwise permitted by this chapter, including sanctions or actions which are more stringent then those imposed by the foreign jurisdiction.
III. The board may adopt summary procedures for handling proceedings brought under this chapter, but shall furnish the respondent at least 10 days’ written notice and a reasonable opportunity to be heard. The board may require a licensee, permittee, registrant, or certificate holder to suspend practice in this state as a condition of postponing a hearing date established for allegations brought under this section.
7 Pharmacists; Investigatory Powers of the Board; Registrants, Permittees Added. Amend RSA 318:30 to read as follows:
318:30 Investigatory Powers of the Board; Complaints.
I. The board may investigate possible misconduct by licensees, permittees, registrants, certificate holders, applicants, and any other matters governed by the provisions of this chapter and RSA 318-B. Investigations may be conducted with or without the issuance of a board order setting forth the general scope of the investigation. Board investigations and any information obtained by the board pursuant to such investigations shall be exempt from the public disclosure provisions of RSA 91-A, unless such information subsequently becomes the subject of a public disciplinary hearing. However, the board may disclose information obtained in an investigation to law enforcement or health licensing agencies in this state or any other jurisdiction, or in accordance with specific statutory requirements or court orders.
II. The board may appoint legal counsel, technical advisors or other investigators to assist with any investigation and with adjudicatory hearings.
III. The board may commence a formal or informal investigation, or an adjudicative hearing, concerning allegations of misconduct and other matters within the scope of this chapter on its own motion whenever it has a reasonable basis for doing so, and the type of procedure chosen shall be a matter reserved to the discretion of the board. Investigations may be conducted on an ex parte basis.
IV.(a) The board may administer oaths or affirmations, preserve testimony, and issue subpoenas for witnesses and for documents during any formal investigation or adjudicatory hearing. The board may also subpoena patient records, as provided in paragraph V, during informal investigations.
(b) Subpoenas not covered by paragraph V shall be served in accordance with the procedures and fee schedules established by the superior court, except that:
(1) Persons licensed or registered by the board shall not be entitled to a witness fee or mileage expenses for travel within the state[;].
(2) Witness fees and mileage expenses need not be tendered in advance if the subpoena is annotated “Fees Guaranteed by the New Hampshire Board of Pharmacy.”
(3) The respondent shall be allowed at least 48 hours to comply.
V. The board may at any time subpoena medical and pharmacy records from its licensees and permittees and from physicians, dentists, veterinarians, advanced registered nurse practitioners, hospitals, and other health care providers or facilities licensed by or certified in this state. Such subpoenas shall be served by certified mail or by personal delivery to the address shown on the licensee’s or permittee’s current license or permit, and no witness or other fee shall be required. A minimum of 15 days’ advance notice shall be allowed for complying with a subpoena duces tecum issued under this chapter.
VI. Persons holding or applying for licenses or other privileges granted by the board shall keep the board informed of their current business and residence addresses. A licensee, permittee, or registrant shall receive adequate notice of any hearing or other action taken under this chapter if notice is mailed in a timely fashion to the most recent home or business address furnished to the board by the licensee, permittee, or registrant.
VII. Complaints of licensee misconduct shall be in writing and shall be treated as petitions for the commencement of a disciplinary hearing. The board shall fairly investigate all complaints to the extent and in the manner warranted by the allegations. A complaint which fails to state a cause of action may be summarily denied in whole or in part. Some or all of the allegations in a complaint may be consolidated with another complaint or with issues which the board wishes to investigate or hear on its own motion. If investigation of a complaint results in an offer of settlement by the licensee, permittee, or registrant, the board may settle the allegations against the licensee, permittee, or registrant without the consent of the complainant, provided that material facts are not in dispute and the complainant is given an opportunity to comment upon the terms of the proposed settlement.
VIII. At the commencement of an adjudicatory proceeding, or at any time during a formal or informal investigation, and without issuing a subpoena, the board may mail a statement of the issues being investigated or heard to a licensee or other person who is a proper subject of inquiry and require that licensee or other person to provide a detailed and good faith written response to such statement. The board may also require the licensee or other person to furnish complete copies of appropriate office records concerning any patient whose treatment is relevant to the matters at issue. The licensee or other person shall respond to such request within a reasonable time period of not less than 15 days, as the board may specify in its written request.
8 Pharmacists; Temporary Suspension Where Imminent Threat; Registrants, Permittees Added. Amend RSA 318:30-a to read as follows:
318:30-a Temporary Suspension Where Imminent Threat. In cases involving imminent danger to life or health, the board may order suspension of a license, permit, registration, certification, or privilege granted under this chapter pending hearing for a period of no more than 60 days. In such cases, the basis for the board’s finding of imminent danger to life or health shall be reduced to writing and combined with a hearing notice which complies with RSA 318:31, II and RSA 541-A:31, III. Notwithstanding the requirements of RSA 541-A:30, III, the board’s hearing may commence as much as 30 days after the date of the order suspending the license, permit, registration, or certification. If the board does not commence the hearing within 30 days the suspension order shall be automatically vacated, but a licensee, permittee, registrant, or certificate holder shall be allowed additional time to prepare for or to complete a hearing under this section only by agreeing to a further suspension commensurate with the additional time extended.
9 Prescriptions; Electronic Transmission. Amend RSA 318:47-c to read as follows:
318:47-c Prescriptions. A prescription may be written [or], oral, or electronically transmitted. All oral prescriptions shall be immediately reduced to writing by the pharmacist or authorized technician receiving the oral prescription and shall indicate at least the name of the patient; the name, strength, and quantity of the drug prescribed; any directions specified by the prescriber; the name of the practitioner prescribing the medication; the date the prescription was ordered; a statement that the prescription was presented orally; and the name of the pharmacist who took the verbal order. The pharmacist who dispensed an original prescription shall indicate on the face of the prescription at least the assigned prescription identification number; the date of dispensing; the quantity actually dispensed; and his or her name or initials. The prescription shall be filed numerically by the assigned identification number for a period not less than 4 years. Such prescription files shall be open to inspection by the pharmacy board and its agents.
10 Sale of Hypodermic Syringe; Podiatrist Added. Amend RSA 318:52-c, I(a) to read as follows:
(a) Hypodermic syringes, needles or any instrument adapted for the administration of drugs by injection shall not be sold except in registered pharmacies. No person shall sell, furnish, or give to any person, under 18 years of age, an instrument commonly known as a hypodermic syringe, hypodermic needle or any instrument adapted for the administration of drugs by injection without the written or oral prescription of a duly licensed physician, dentist, veterinarian, podiatrist, or advanced registered nurse practitioner. Such prescription shall contain the name and address of the patient, the date of the prescription, the description of the instrument prescribed, and the number of instruments prescribed.
11 Controlled Drug Act; Sale by Pharmacists; Electronic Prescriptions. Amend RSA 318-B:9, I to read as follows:
I. A pharmacist, in good faith and in the course of his or her professional practice, may sell and dispense controlled drugs exempt under the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended, and federal food and drug laws from prescription requirements. A pharmacist, in good faith, may sell and dispense controlled drugs requiring prescriptions to any person upon the written or electronically transmitted prescription of a practitioner, provided it is properly executed, dated and when required by law, manually or electronically signed by the person prescribing on the day when issued and bears the full name and address of the patient for whom, or of the owner of the animal for which, the drug is dispensed, or upon oral prescription, in pursuance of regulations promulgated by the Department of Justice of the United States, under the provisions of the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended where applicable, provided said oral prescription is promptly reduced to writing by the pharmacist or authorized technician, stating the name of the practitioner so prescribing, the date, the full name and address of the patient for whom, or the owner of the animal for which, the drug is dispensed, and, in all instances, the full name, address and registry number under the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended, or federal food and drug laws of the person so prescribing. If the prescription is for an animal, it shall state the species of animal for which the drug is prescribed. The person filling the prescription shall [write] indicate the date of filling and his [own signature] or her name on the face or record of the prescription. The prescription shall be retained on file by the proprietor of the pharmacy in which it is filled for a period of 4 years so as to be readily accessible for the inspection of any officers engaged in the enforcement of this chapter. The prescription as to a controlled drug may be refilled pursuant to the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended. The person refilling a prescription for a controlled drug shall record on the prescription record the date of refill, the quantity dispensed, and his or her initials.
12 Controlled Drug Act; Sale by Pharmacists; Electronic Prescriptions. Amend RSA 318-B:9, III to read as follows:
III. Prescriptions [written] issued by practitioners for controlled drugs shall be executed in clear, concise, readable form [and may be typewritten]. Each prescription shall contain the following information and comply with the following requirements:
(a) The full name and complete address of the patient or of the owner of the animal for which the drug is prescribed.
(b) The day, month, and year the prescription is issued.
(c) The name of the controlled drug prescribed. Only one controlled drug shall appear on a prescription blank.
(d) The strength of the controlled drug prescribed.
(e) The specific directions for use of the controlled drug by the patient.
(f) No refills shall be authorized for controlled drugs in schedule II of the current chapter 21, Code of Federal Regulations.
(g) The federal Drug Enforcement Administration registration number of the practitioner.
(h) The practitioner shall manually or electronically sign the prescription [in ink] on the date of issuance.
(i) The practitioner’s full name shall be printed, rubber stamped, or typewritten above or below the [hand-written] manual or electronic signature.
(j) A practitioner shall not issue a prescription in order to obtain controlled substances for the purpose of general dispensing to his or her patients.
(k) A practitioner shall not issue a prescription to himself or herself or his or her immediate family which includes a spouse, children or parents.
(l) A prescription shall be deemed invalid if it is not filled within 6 months from the date prescribed.
13 Flunitrazepam; Controlled Drug Act; GHB and Ketamine Hydrochloride Removed. RSA 318-B:1-c is repealed and reenacted to read as follows:
318-B:1-c Flunitrazepam.
I. The legislature intends that the provisions of paragraph III of this section shall remain in effect until such time as flunitrazepam is scheduled by the commissioner of the department of human services in accordance with and pursuant to RSA 318-B.
II. The legislature finds that flunitrazepam, marketed under the trade name rohypnol, which has a sedative, hypnotic, and amnesiac effect, has no acceptable medical uses in the United States and carries a high potential for abuse. Therefore, flunitrazepam meets the criteria for placement on schedule I of controlled drugs.
III. Notwithstanding the provisions of RSA 318-B:1-a, relative to scheduling by rulemaking of the commissioner of the department of health and human services, flunitrazepam shall be scheduled as a schedule I controlled drug:
14 Statement of Purpose. The general court recognizes that New Hampshire’s lower-income uninsured residents pay too much for prescription medication. The general court recognizes that it is difficult or impossible for lower-income residents who do not have insurance to pay for medications and that this results in poorer health, higher medical costs, and increased reliance on medicaid. Therefore, to reduce current and future medicaid expenditures and improve the health of New Hampshire’s population, the general court hereby creates the New Hampshire Rx plus program which will allow lower-income uninsured persons the opportunity to buy prescription drugs at discount prices.
15 New Chapter; New Hampshire Rx Plus Program for Prescription Drugs. Amend RSA by inserting after chapter 161-J the following new chapter:
CHAPTER 161-K
161-K:1 Definitions. In this chapter:
I. “Commissioner” means the commissioner of the department of health and human services.
II. “Department” means the department of health and human services.
161-K:2 New Hampshire Rx Plus Program Established. The department shall establish the New Hampshire Rx plus program for prescription drugs. The New Hampshire Rx plus program shall be available to individuals and families with incomes of not more than 350 percent of the federal poverty level that either lack insurance coverage for prescription medications or that have reached the limits of their prescription medication insurance coverage. Benefits shall include the right to purchase prescription medications included on the medicaid preferred drug list from participating pharmacies at average wholesale prices less 10 percent. The department shall negotiate medicaid level or greater rebates with manufacturers for all products available to Rx plus beneficiaries. Rx plus discount prices shall be based on average wholesale price (AWP) less 10 percent and medicaid level or greater rebates voluntarily received from manufacturers on prescription medications purchased by Rx plus beneficiaries less dispensing fees and the department’s administrative costs relating to Rx plus. If the department contracts with a commercial organization to manage the Rx plus rebate negotiations, the contract shall provide that the organization shall not retain rebate moneys.
161-K:3 Rx Plus Fund Established. There is hereby established in the office of the state treasurer a fund to be known as the Rx plus fund. All payments of discounts received by the department as a result of purchases by Rx plus beneficiaries, appropriations to the fund, and interest on the fund shall be deposited in the fund. Moneys in this fund shall be nonlapsing and continually appropriated to the department and may be expended on administrative costs, including contracted services, and reimbursement for pharmacist dispensing fees relating to the Rx plus program and to lower the discount prices available to Rx plus beneficiaries. The department may also reserve moneys in the fund to limit fluctuations in discount prices.
161-K:4 Contracts. The department may enter into contracts relating to this chapter, including contracts relating to program outreach, eligibility determinations, including self-declaration of income as a cost-saving measure, administration, and price and discount negotiations, and recovery. No such contracts shall permit a contractor to receive compensation or other benefit from any pharmaceutical industry entity unless the terms of such compensation or benefits and potential conflicts of interest are disclosed to the department. Such contracts shall guarantee patient confidentiality as to any records shared between the department, contractors, drug industry entities, and pharmacies.
161-K:5 Rulemaking. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to:
I. The application process.
II. Rx plus discount prices pursuant to RSA 161-K:2.
III. The administration of the Rx plus fund established in RSA 161-K:3.
IV. The contracting process, including confidentiality procedures, under RSA 161-K:4.
16 New Subparagraph; Rx plus Fund. Amend RSA 6:12, I by inserting after subparagraph (234) the following new subparagraph:
(235) Moneys deposited in the Rx plus fund pursuant to RSA 161-K:3.
17 Effective Date. This act shall take effect 60 days after its passage.
LBAO
05-0187
5/16/05
HB 114 FISCAL NOTE
AN ACT relative to the regulation of pharmacists and pharmacy technicians by the pharmacy board and establishing the New Hampshire Rx plus program for prescription drugs.
FISCAL IMPACT:
The Department of Health and Human Services indicates this bill, as amended by the Senate (Senate Amendment #2005-1286s), will increase state expenditures and revenues by an indeterminable amount in FY 2006 and each year thereafter. There will be no fiscal impact on county and local revenue or expenditures.
METHODOLOGY:
The Department of Health and Human Services made the following assumptions:
• This bill creates a state-sponsored pharmacy program similar to programs started in Maine and Hawaii. Pharmacies that choose to participate in the program will provide certain “preferred” prescription drugs at “average wholesale price less 10%” for residents with household incomes under 350% of the federal poverty level and with no insurance coverage, or who have reached the limits of their prescription coverage. The state will negotiate rebates with pharmaceutical manufacturers to support the cost of the program and provide additional savings to enrollees.
• This program will be implemented in two phases. In the first phase, which would start in FY 2006, pharmacies agreeing to participate would provide discounted prices to enrollees. The current rates paid by the Maine program are slightly higher than New Hampshire’s Medicaid rates, and only one-third of the pharmacies in Maine participate in the program. In the second phase, which would start in FY 2007, the state would negotiate rebates with pharmaceutical manufacturers based on a preferred drug list. The preferred drugs would include pharmaceuticals for which the manufacturers have agreed to offer rebates. Based on Hawaii’s experience, the pharmaceutical manufacturers would consider negotiating rebates when enrollment in the program reaches a threshold of 50,000 people. The Department assumed the program would reach this threshold in FY 2007, and used an enrollment of 50,000 to estimate the expenditures and revenues. Rebates would be deposited in the Rx Plus Fund and used to fund the program, and any excess revenue would eventually provide additional point of sale savings to enrollees.
• State appropriations will be necessary to start the program. The Department assumes that eventually the program would reach a break-even point and program costs would be covered by rebates. Rebates would not be sufficient to cover the start up and operating costs for the first two or three years. Manufacturer’s rebates are not available until several months after the medications are dispensed and the revenue would increase gradually as enrollment increases.
• The Department assumed the program will not be required to repay the initial state general fund appropriation. Initial costs would include: outreach and marketing, development of an enrollment system, and program staff. Based on staffing in the Hawaii program, staff would include a program director, an outreach specialist and five administrative staff to perform data-entry and process enrollment applications.
• In addition, costs will be incurred to support the second phase of the program. Systems and administrative capacity would be necessary to collect the pharmacy data needed to support the rebate calculations and claims, and to distribute excess rebate funds to pharmacies for rebate-based point of sale discounts. The Department assumed a Pharmacy Benefits Manager (PBM) under contract with the state would perform the functions. These costs cannot be determined without detailed discussions with potential vendors.
Based on these assumptions, the Department estimated the following costs to start and operate the program in the first year:
Marketing $300,000
Enrollment System $400,000
Program Staff: Seven employees, benefits and current expenses $350,000
Second Phase costs through PBM Unknown
The Department assumed the program would begin to receive rebate revenue in FY 2007, which would start to offset the ongoing operating costs. The Department estimated the rebate revenues as follows:
FY 2006 FY 2007 FY 2008 FY 2009
Estimated Rebate Revenue $ 0 $285,000 $780,000 $1,650,000
Due to the uncertainties concerning enrollment, ongoing costs, and the cost of the PBM contract, the Department cannot accurately estimate the revenue and expenditures in the future years or determine when the program will break-even and rebate revenue will fund all of the operating costs. The amounts presented are a best estimate based on the assumptions made.
The Department indicated information from Maine’s program suggests enrollees are saving about 15% off the retail prices on brand name drugs, and 60% off retail prices on generic drugs.
The Board of Pharmacy states the portion of this bill that makes various changes to the regulation by the Board of pharmacists, pharmacy technicians, and the issuing of prescriptions will have no fiscal impact.