SB 119-FN - AS INTRODUCED
2025 SESSION
25-0362
05/06
SENATE BILL 119-FN
AN ACT relative to Medicaid pharmaceutical services.
SPONSORS: Sen. Gray, Dist 6
COMMITTEE: Health and Human Services
-----------------------------------------------------------------
ANALYSIS
This bill directs pharmacists to dispense brand name drugs to Medicaid beneficiaries when the brand name drug is on the department of health and human services preferred drug list. The bill also directs the department to develop a standing order for certain Medicaid-covered, over-the-counter medications, medical supplies, and laboratory tests when deemed medically necessary and cost effective by the department.
The bill is a request of the department of health and human services.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
25-0362
05/06
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Five
AN ACT relative to Medicaid pharmaceutical services.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Purpose and findings. The general court hereby finds that:
I. The state of New Hampshire has a substantial interest in ensuring that the Medicaid program is able to provide beneficiaries the greatest access possible to necessary pharmaceutical products. A means of achieving access is to attain best net cost possible on pharmaceutical products.
(a) The net cost of a pharmaceutical product is determined by subtracting the pharmaceutical manufacturer rebate revenue the Medicaid program receives from the total drug cost.
(b) The department of health and human services will continue to optimize its Medicaid preferred drug list to provide Medicaid beneficiaries with medically necessary access to pharmaceutical products.
(c) Collectively, this will allow for the lowest net cost and improve access to therapies and streamline prescribing for providers through a more standardized preferred drug list across all Medicaid pharmacy programs.
II. Accordingly, the general court finds that, RSA 126-A:3, V must be amended to remove any barriers to these policy goals.
2 Department of Health and Human Services; General Provisions. Amend RSA 126-A:3, V to read as follows:
V. Pharmacists shall substitute generically equivalent drug products for all legend and non-legend prescriptions paid for by the department of health and human services, [including the Medicaid program,] unless the prescribing practitioner specifies that the brand name drug product is medically necessary. Such notification shall be in the practitioner's own handwriting or as otherwise authorized by law or regulation and shall be retained [in the pharmacist's file] by the pharmacy. Pertaining to Medicaid, pharmacists shall dispense brand name drug products to Medicaid beneficiaries when the brand name drug product is listed on the department’s Medicaid preferred drug list, and not substitute generically equivalent drugs. The provisions of paragraph III shall not apply to the dispensing by a pharmacy for medical assistance reimbursement for legend and non-legend drugs. The commissioner, in consultation with pharmacy providers, shall establish medical assistance reimbursement for legend and non-legend drugs. For Medicaid fee for service [clients] beneficiaries, no prior authorization [for generically equivalent drugs shall be required] shall be required for generic drug products unless the drug class is recommended by the drug utilization review board for clinical appropriateness and safety utilization review.
3 New Paragraph; Department of Health and Human Services; General Provisions. Amend RSA 126-A:3 by inserting after paragraph V the following new paragraph:
V-a.(a) When deemed medically necessary and cost effective by the department of health and human services’ chief medical officer, a standing order may be issued by the chief medical officer for certain Medicaid covered over-the-counter (non-legend) medications, medical supplies, and laboratory tests. Such standing order shall be reviewed annually by the chief medical officer for continuation or discontinuation of the standing order.
(b) No health care professional, acting in good faith and with reasonable care, who issues a standing order, or who dispenses, or distributes over-the-counter (non-legend) medications, medical supplies, or laboratory tests by standing order shall be subject to any criminal or civil liability, or any professional disciplinary action, for any action authorized by this paragraph or any outcome resulting from an action authorized by this paragraph.
4 Effective Date. This act shall take effect July 1, 2025.
25-0362
1/19/25
SB 119-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to Medicaid pharmaceutical services.
FISCAL IMPACT:
The Office of Legislative Budget Assistant is unable to complete a fiscal note for this bill as it is awaiting information from the Department of Health and Human Services. The Department was contacted on 12/16/24 for a fiscal note worksheet. When completed, the fiscal note will be forwarded to the Senate Clerk's Office.
AGENCIES CONTACTED:
Department of Health and Human Services
| Date | Body | Type |
|---|---|---|
| Feb. 6, 2025 | Senate | Hearing |
Jan. 29, 2025: Hearing: 02/06/2025, Room 101, LOB, 10:00 am; SC 8
Jan. 22, 2025: Introduced 01/09/2025 and Referred to Health and Human Services; SJ 3