Bill Text: HI HCR128 | 2011 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Task Force; Policy; Regulation of Pharmacy Benefit Management Companies; Patients Right to Select Their Own Pharmacy Provider

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Passed) 2011-04-27 - (H) Resolution adopted in final form. [HCR128 Detail]

Download: Hawaii-2011-HCR128-Introduced.html

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HOUSE OF REPRESENTATIVES	H.C.R. NO.	128
TWENTY-SIXTH LEGISLATURE, 2011
STATE OF HAWAII

HOUSE CONCURRENT

RESOLUTION

 

 

REQUESTING THE GOVERNOR OF THE STATE OF HAWAII TO CONVENE A TASK FORCE TO REVIEW POLICIES AND PROCEDURES FOR STATE FUNDED DRUG COVERAGE PROGRAMS AND SERVICES ON THE USE OF REBATES, MANUFACTURER PAYMENTS, INCENTIVES, PRESCRIPTION REIMBURSEMENTS AND PATIENTS RIGHT TO SELECT A PHARMACY PROVIDER OF THEIR OWN CHOICE.

 

 

 

 

     WHEREAS, Pharmacy Benefit Management Companies (PBMC) are intermediaries that negotiate services and costs between pharmaceutical companies and third payer parties, such as insurance companies, businesses, and cash-paying customers; and

 

     WHEREAS, the Pharmacy Benefit Management Institute (PBMI) reported that the combined market share of prescriptions processed by MedCo, Express Scripts and CVS/Caremark in the third quarter of 2010 has 47.17% of all prescriptions in the United States; and

 

     WHEREAS, the Legislature seeks to establish a task force that will regulate the licensing of pharmacy benefit management companies, ensure financial reliability, mandate full disclosure of drug costs and financial contracts while eliminating the term "mandatory" from any pharmacy benefit contract; and

 

     WHEREAS, within our State, there is no standardized or integrated reporting mechanism across service environments and consequently, pharmacy providers such as chain drug stores and independent pharmacies, are currently subjected to unregulated auditing practices that attempts to recoup from, gather negative data from and/or penalize; and

 

     WHEREAS, there should be guidelines developed that encourage audits to be performed in a fair and balanced manner and legislation drafted that establish a more regimented and reliable audit procedure; and

 

      BE IT RESOLVED by the House of Representatives of the Twenty-sixth Legislature of the State of Hawaii, Regular Session of 2011, the Senate concurring, that the Governor is requested to convene a task force to suggest prohibited activities by a PBMC and define appropriate penalties for violations of prohibited activities, design a base for the Insurance Commissioner to use as a guideline for a schedule of allowable acquisition costs and professional dispensing fees, determine the feasibility of a licensure fee, make recommendations on complete disclosures of transactions made to pharmacies, review potential alternatives to the mandated mail order formula and develop a consistent statewide policy; and

    

     BE IT FURTHER RESOLVED that the Governor involve representatives of all relevant agencies and organizations, both public and private, in the convening of the task force; and

 

     BE IT FURTHER RESOLVED that the purpose of the task force is to review the policies of the state-funded prescription drug coverage program and its services and the customer complaints with the forced use of the mail order program ; and

 

     BE IT FURTHER RESOLVED that the task force is requested to:

 

     (1)  Suggest prohibited activities by a PBMC and define appropriate penalties for violations of prohibited activities;

 

     (2)  Delineate strategies and methodologies for the Insurance Commissioner to use as a guideline for a schedule of allowable acquisition costs and professional dispensing fees;

 

     (3)  Determine the feasibility of implementing a licensure fee $_______ per year for any PBM applying for licensure in the State of Hawaii,

 

     (4)  Make recommendations on the complete disclosure to the purchaser, DCCA and or Insurance Commissioner a complete report of all rebates, manufacturer payments, incentives, prescription reimbursements to pharmacies on a quarterly basis;

 

     (5)  Review potential alternatives to the use of the mandated mail order formula, and incorporate these alternatives into the protocols of the various options available allowing for "Patients Right to Choose Their Own Pharmacy" and timely/equal access to prescription medication and pharmacy personnel; and

 

     (6)  Develop specifications for a quality monitoring system that:

 

          (A)  Can be replicated across departments for   consistency;

 

          (B)  Prohibit:

                   (1)  Manipulation of co-payments or other                 tangible incentives,

                   (2)  Differential reimbursements to                       different pharmacy providers and

                   (3) Mandatory mail order program for                     prescription drug coverage after three                    fills on maintenance medications.

 

          (C)  Audit pharmacies to assure formulary compliance,      accurate dispensing and patient safety and will      overall enhance the quality of care provided;

 

          (D)  Track serious injuries/ problems from any provider, in any setting, whether it be mail order or local pharmacy; and

 

          (E)  Establishes guidelines for quality reviews and data analysis to identify trends; and

 

     BE IT FURTHER RESOLVED that the task force membership shall include nine members as follows:

 

     (1)  A member of the House of Representatives appointed by the Speaker of the House of Representatives;

 

     (2)  A member of the Senate appointed by the President of the Senate;

 

     (3)  The Director of Health or the Director's designee;

 

     (4)  The Insurance Commissioner or the Insurance Commissioner's designee;

 

     (5)  Two members selected by the Director of Health who are from different private service providers;

 

     (6)  Two members selected by the Employee Union Trust Fund (EUTF) Board who are members of the EUTF;

 

     (7)  Three members appointed by the Governor from a list submitted by the Speaker of the House of Representatives and President of the Senate, with each member representing a different organization that represents pharmacists and their consumers, one of which must be from the island of Kauai; and

 

     BE IT FURTHER RESOLVED that the members of the task force shall serve without compensation and shall receive no reimbursement for expenses.

    

     BE IT FURTHER RESOLVED that the task force is requested to submit to the Legislature an annual report no later than twenty days prior to the start of the Regular Session of 2012, on its findings and recommendations, including any legislation or funding appropriation necessary to implement the recommended policy; and

 

     BE IT FURTHER RESOLVED that the task force shall cease to exist on May 1^st, 2012.

    

     BE IT FURTHER RESOLVED that certified copies of this Resolution be transmitted to the Auditor, the Insurance Commissioner and the Director of Health, who in turn is requested to transmit copies to each insurer in the State that issues health insurance policies.

 

 

	OFFERED BY:	_____________________________

Report Title: 

Task Force; Policy; Regulation of Pharmacy Benefit Management Companies; Patients Right to Select Their Own Pharmacy Provider