LD 1288
pg. 1
LD 1288 Title Page An Act To Increase Public Access to the Prior Authorization Process Page 2 of 2
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LR 1737
Item 1

 
Be it enacted by the People of the State of Maine as follows:

 
Sec. 1. 22 MRSA §3174-DD is enacted to read:

 
§3174-DD.__Drug Utilization Review Committee

 
1.__Authority.__The department has the authority to
determine which prescription and over-the-counter drugs are
subject to prior authorization and coverage under the
MaineCare program.

 
2.__Drug Utilization Review Committee.__In order to make
determinations regarding which prescription and over-the-
counter drugs are subject to prior authorization, the Drug
Utilization Review Committee, referred to in this section as
"the committee," is established.

 
A.__The committee is composed of an equal number of
actively practicing physicians and actively practicing
pharmacists, totaling not fewer than 6 individuals.__The
department shall appoint the members of the committee and
establish their terms.

 
B.__Public notice of the date, time and location of all
meetings of the committee must be made in accordance with
Title 1, section 406 at least 7 days in advance of the
meeting.__This notice must also include a list of all
drugs to be considered for prior authorization at that
meeting.__The meetings must be considered public
proceedings, for purposes of Title 1, chapter 13.__Members
of the public, including health care providers and drug
manufacturers, who are physically present at committee
meetings must be granted reasonable opportunity to address
the committee prior to any vote.

 
C.__At the conclusion of a meeting pursuant to paragraph
B, committee members shall record their vote for each drug
on a form to be supplied at each meeting.__After adding or
deleting a drug from the list of drugs that require prior
authorization, the committee shall issue written findings
setting forth the evidentiary basis for its decision.__
These findings must address, without limitation, all
relevant clinical data, as well as the likelihood that
subjecting a drug to prior authorization will cause
adverse medical results or affect patients' access to all
medically necessary outpatient drugs.__A vote of at least
2/3 of the committee members present is required to add or
delete a drug from the list of drugs that require prior
authorization.


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