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

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-Amended.html

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HOUSE OF REPRESENTATIVES	H.C.R. NO.	128
TWENTY-SIXTH LEGISLATURE, 2011		H.D. 1
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' RIGHTS TO SELECT A PHARMACY PROVIDER OF THEIR OWN CHOICE.

 

 

 

     WHEREAS, pharmacy benefit management companies 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 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 percent 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, and mandate full disclosure of drug costs and financial contracts, while eliminating the term "mandatory" from any pharmacy benefit contract; and

 

     WHEREAS, within the 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 subject to unregulated auditing practices that attempt to recoup from them, gather negative data from them, and/or penalize them; and
     WHEREAS, guidelines should be 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:

 

(1)  Recommend prohibited activities by pharmacy benefit management companies;

 

(2)  Define appropriate penalties for violations of prohibited activities by pharmacy benefit management companies;

 

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

 

(4)  Determine the feasibility of implementing a licensure fee of $        per year for any pharmacy benefit management company applying for licensure in the State;

 

(5)  Make recommendations on the complete disclosures of transactions made to pharmacies;

 

(6)  Make recommendations on the complete disclosures to the purchaser, Department of Commerce and Consumer Affairs, and/or Insurance Commissioner, including a complete report of all rebates, manufacturer payments, incentives, and prescription reimbursements to pharmacies on a quarterly basis;

 

(7)  Review potential alternatives to the use of the mandated mail order formula and incorporate the alternatives into the protocols of the various options available allowing for "Patients Right to Choose Their Own Pharmacy" to better address language barrier issues and to provide timely and equal access to prescription medication and pharmacy personnel;

 

(8)  Develop a consistent statewide policy and specifications for a quality monitoring system that:

 

(A)  Can be replicated across departments for consistency;

 

(B)  Prohibit manipulation of co-payments or other tangible incentives, differential reimbursements to different pharmacy providers, and mandatory mail order program for prescription drug coverage after three fills on maintenance medications;

 

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

 

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

 

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

         

          and

    

     (9)  Review the policies of the state-funded prescription drug coverage program and its services, and customer complaints with the forced use of the mail order program;

 

and

 

     BE IT FURTHER RESOLVED that the task force comprise 13 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 Hawaii Employer-Union Health Benefits Trust Fund Board of Trustees who are members of the Hawaii Employer-Union Health Benefits Trust Fund; and

 

     (7)  Five 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, and at least one from each of the islands of Hawaii, Kauai, Maui, and Oahu;

 

and

 

     BE IT FURTHER RESOLVED that the Governor is requested to 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 members of the task force serve without compensation and receive no reimbursement for expenses; and

 

     BE IT FURTHER RESOLVED that the task force shall cease to exist on May 1, 2012; and

    

     BE IT FURTHER RESOLVED that the task force is requested to submit to the Legislature a report, including its findings, recommendations, and any proposed legislation and funding appropriation necessary to implement the recommended policy, no later than 20 days prior to the convening of the Regular Session of 2012; and
     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Auditor, the Insurance Commissioner, and the Director of Health, who in turn are requested to transmit copies to each insurer in the State that issues health insurance policies.

Report Title: 

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