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May was a busy month for Ohio’s legislators as they grappled with how to come up with an additional $9 billion to balance the state’s budget. Along with increasing the sales tax on cigarettes 31 cents, the Ohio Legislature incorporated House Bill 4 into the budget bill, Senate Bill 261. HB 4 is the Governor’s proposal to create the Golden Buckeye Prescription Discount Card, and was introduced in the Ohio House of Representatives during Governor Taft ’s State of the State address in 2001. The specific version of HB 4 that is contained in the budget bill is the 10th version of the bill. Out of the 12 versions that had been debated, this form contains legislative language that requires the pass-through of a portion of rebate monies from the administrator of this program to both senior citizens and participating pharmacies.

Additionally, the bill states that the Ohio Department of Aging is required to complete an annual survey of the program, and look at the effectiveness of the program and the cost implications on participating pharmacies.
After 18 months of extensive lobbying and negotiating on HB 4, the Taft Administration was anxious to have HB 4 enacted in Ohio. Before being incorporated in the state budget bill, HB 4 was in the Ohio Senate Health & Family Services Committee where it received hearings. The process to create the Senior Prescription Drug Card in Ohio will be a lengthy one, as rules for the program will be created by the Ohio Department of Aging, and then must be approved by the Joint Committee on Agency Rule Review (JCARR). Additionally, the State Controlling Board must approve all bids for the administration of the program before the Ohio Department of Aging can initiate the program. OPA will continue to be an active part in the ongoing process of implementing HB 4 language in the budget bill. The debate over what items were ultimately going to be placed in SB 261 was not open for discussion. Most of the discussions on this legislation were between top administration officials behind closed doors, often into the late evening hours. During the two-week long process, the Speaker of the Ohio House of Representatives searched for yes votes among his Republican members, while rumors circulated around the Statehouse at a fast rate. In the end, both the Ohio Senate and Ohio House of Representatives passed a bill that was signed by Governor Taft. The Governor did utilize his veto powers for several items, though none of those were related to HB 4 language.

In addition to HB 4 being included in SB 261, the bill also contains language that permits the Ohio Department of Jobs and Family Services Director to establish a supplemental rebate program under which drug manufacturers may be required to provide the department a supplemental rebate as a condition of having their drug products covered without prior approval. This proposal provides an exemption for any drugs used to treat mental illness and HIV/AIDS. Governor Taft vetoed the definition of supplemental rebate in SB 261, and stated that the inclusion of that language would hinder the Ohio Department of Jobs and Family Services’ ability to create the most comprehensive program for the state.

Lastly, SB 261 contains a provision that authorizes the Ohio Department of Jobs and Family Services to examine instituting a co-payment program under Medicaid. The Department will examine federal restrictions on co-payments and analyze if a co-payment program would reduce inappropriate use of medical goods and services in Ohio’s Medicaid program.

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