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Legislative Update December 2003: HB 311 and SB 138: Ohio’s Best Rx Program
Also: Current and Proposed Legislation
Legislative Update December 2003Kelly Vyzral, Director of Government Affairs
HB 311 and SB 138: Ohio’s Best Rx Program
As we head into the holiday season, legislative activity has slowed down on all but a few priority bills. HB 311, and SB 138, Ohio’s Best Rx program, is at the top of the priority list. With only four more Session days scheduled in the early part of December, activity will be fast and furious to finish this legislation by the end of the year. Although OPA has made some positive changes in the bill, most importantly making it a voluntary program, at the time of printing, we still have several concerns with the legislation. The following list constitutes the major concerns of the Ohio Pharmacists Association in regards to HB 311, the Ohio Best Rx program.
- We believe that the pricing formula proposed under the current language is unnecessarily cumbersome, time-consuming and will ultimately add to the operational costs of the program. We propose using a more reasonable reimbursement structure. Prices shall be updated on a nightly basis and claims shall be paid within a two-week period, or by electronic funds transfer.
- The length of contract should be one year, with an industry standard 30-day opt out clause. This clause would state that a terminal distributor may cancel its participation in the Ohio’s Best Rx program at any time and for any reason by submitting a written statement to that effect 30 days in advance to the Ohio Department of Job and Family Services.
- We have asked that anti-coercion language be added to the legislation. This would prohibit an administrator from requiring a pharmacy to participate in the program’s network as a condition of participating in another network operated by the same administrator. We feel this is necessary to make this a truly voluntary program, and to prevent language from being added to contracts at a later time.
- We have requested that the language, limiting pharmacists to dispensing a 30-day supply of drugs, be stricken from the bill. These are cash paying customers, using a discount card, and the pharmacist should be able to completely fill their prescription as written by the physician. This will minimize both cost and burden to the program participant.
- The oversight committee must include members representing pharmacy. The Ohio Pharmacists Association should appoint these members. Since the committee will be judging the effectiveness of the program, and making recommendations for program improvements, it is common sense that those on the front line of the program, pharmacists, are involved. We also feel it is important that the legislative members of the committee are allowed to appoint designees to attend in their place. This will safeguard their representation on the committee.
Current Bills
As was stated before, legislation not on a priority track slowed down considerably in November and December. This is the case with much of the legislation we have been following. While the legislature will resume a more normal schedule in January, it must be remembered that 2004 is an election year, and campaigns for both the primary and the general election will keep legislators very busy.
HB 146: Diabetes Coverage.
This bill, which would require health plans to cover treatment of diabetes, has been promised a committee vote by the end of the year. It did not have a hearing in November, but with 15 of the 21 committee members as co-sponsors, it has a good chance of making it out of Health committee.
HB 253: Freedom of Access.
Introduced by Rep. Tom Patton, this bill would allow nonparticipating pharmacies to enter into contracts if they accept the same terms and conditions. It looks like this bill will have sponsor testimony in the New Year. This legislation is very important and we will be watching it carefully.
SB 43: Uniform Rx Drug Card.
Another important piece of legislation that we will be watching carefully in the New Year is SB 43. We are currently waiting on a redraft of the bill, which will add some insurance information that physicians will also find helpful in filing claims. This legislation has the support of insurance, medical and pharmacy interests, so when the General Assembly resumes business in January, we hope to see quick passage of the bill.
New Legislation
We have one new piece of legislation that has our concern. SB 147, which was introduced by Sen. Lynn Wachtmann, would give physician assistants physician-delegated prescriptive authority. The bill, as currently written, has a negative formulary, no delineated scope of practice, and no authority by the Medical Board. We are concerned about the lack of clinical education and experience involved in obtaining a physician assistant’s license. This legislation has not yet been assigned to a committee.
If you have questions or concerns about any of the bills mentioned in this article, please contact Kelly Vyzral, Director of Government Affairs, at 614.798.0037, or kvyzral@ohiopharmacists.org.
