Revision: Jan. 25, 2018, 10:28 a.m.
SB 591-FN - AS INTRODUCED
2018 SESSION
18-2906
01/03
SENATE BILL 591-FN
AN ACT relative to accreditation of health care providers by pharmacy benefit managers.
SPONSORS: Sen. Soucy, Dist 18; Sen. Reagan, Dist 17; Rep. Rosenwald, Hills. 30; Rep. Keans, Straf. 23
COMMITTEE: Health and Human Services
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ANALYSIS
This bill prohibits certain practices of pharmacy benefit managers except under certain circumstances.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
18-2906
01/03
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eighteen
AN ACT relative to accreditation of health care providers by pharmacy benefit managers.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Subparagraph; Managed Care Law; Provider Contracts; Pharmacy Benefit Managers. Amend RSA 420-J:8, XV by inserting after subparagraph (c) the following new subparagraph:
(d)(1) A pharmacy benefit manager shall not require accreditation of providers other than by the New Hampshire pharmacy board or other state or federal entity.
(2) Notwithstanding subparagraph (1), a pharmacy benefit manager may require accreditation as a specialty pharmacy any pharmacy which dispenses 90 or more specialty drug prescriptions per quarter and whose aggregate average wholesale price in any one quarter is comprised of over 50 percent specialty drugs.
2 Effective Date. This act shall take effect upon its passage.
18-2906
Revised 1/24/18
SB 591-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to accreditation of health care providers by pharmacy benefit managers.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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STATE: | FY 2019 | FY 2020 | FY 2021 | FY 2022 | |
Appropriation | $0 | $0 | $0 | $0 | |
Revenue | Indeterminable | Indeterminable | Indeterminable | Indeterminable | |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable | |
Funding Source: | [ X ] General [ ] Education [ ] Highway [ X ] Other - Federal Medicaid matching funds. | ||||
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COUNTY: |
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Revenue | $0 | $0 | $0 | $0 | |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable | |
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LOCAL: |
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Revenue | $0 | $0 | $0 | $0 | |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable |
METHODOLOGY:
This bill prohibits pharmacy benefit managers from requiring accreditation of providers other than by the NH Pharmacy Board or other state entity, except in the case of specialty pharmacies as defined by the bill. The Insurance Department states it is unable to predict what impact, if any, the bill will have on insurance premiums, and hence the impact on insurance premium tax revenue is indeterminable. The Department of Health and Human Services states that since the pharmacy benefit managers utilized by its fee-for-service program and contracted managed care organizations do not currently require accreditation of providers, the discretion provided by the bill with respect to specialty pharmacies might have the effect of increasing state Medicaid costs by an indeterminable amount. The Department of Administrative Services notes that, since the State's employee and retiree health benefit plan contracts with a third-party prescription vendor, the State may be indirectly impacted by any costs the bill may impose on that vendor.
The New Hampshire Municipal Association and New Hampshire Association of Counties state the bill will have no fiscal impact.
AGENCIES CONTACTED:
Insurance Department, Department of Health and Human Services, Department of Administrative Services, New Hampshire Association of Counties, and New Hampshire Municipal Association