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PUBLIC LAWS OF MAINE
First Regular Session of the 121st

CHAPTER 494
S.P. 590 - L.D. 1634

An Act To Improve the Maine Rx Program

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

     Sec. 1. 22 MRSA c. 603, sub-c. 1 is amended by repealing the subchapter headnote and enacting the following in its place:

SUBCHAPTER 1
MAINE RX PLUS PROGRAM

     Sec. 2. 22 MRSA §2681, as amended by PL 2001, c. 358, Pt. Q, §6 and c. 405, §2 and affected by §3, is further amended by repealing the section headnote and enacting the following in its place:

§2681. Maine Rx Plus Program established

     Sec. 3. 22 MRSA §2681, first ¶, as enacted by PL 1999, c. 786, Pt. A, §3, is amended to read:

     The Maine Rx Plus Program, referred to in this subchapter as the "program," is established to reduce prescription drug prices and to improve the quality of health care for residents of the State. The program is designed for the State to administered by the department and must utilize manufacturer rebates and pharmacy discounts to reduce prescription drug prices. In implementing the program, the State shall serve as a pharmacy benefit manager in establishing rebates and discounts on behalf of qualified residents.

     Sec. 4. 22 MRSA §2681, sub-§§1, 2, 4, 5 and 6, as enacted by PL 1999, c. 786, Pt. A, §3, are amended to read:

     1. Program goals. The Legislature finds that affordability is critical in providing access to prescription drugs for Maine residents. This subchapter is enacted by the Legislature to enable the State to act as a pharmacy benefit manager in order take steps to make prescription drugs more affordable for qualified Maine residents, thereby increasing the overall health of Maine residents, promoting healthy communities and protecting the public health and welfare, and to integrate the program as part of any statewide program for the uninsured. It is not the intention of the State to discourage employers from offering or paying for prescription drug benefits for their employees or to replace employer-sponsored prescription drug benefit plans that provide benefits comparable to those made available to qualified Maine residents under this subchapter.

     2. Definitions. As used in this subchapter, unless the context otherwise indicates, the following terms have the following meanings.

     4. Rebate amount. The commissioner shall negotiate the amount of the rebate required from a manufacturer or labeler in accordance with this subsection.

     5. Discounted prices for qualified residents. Any Each participating retail pharmacy that sells prescription drugs covered by a rebate agreement pursuant to subsection 3 shall discount the retail price of those drugs sold to qualified residents shall sell covered drugs to qualified residents at the lower of the initial discounted price and the secondary discounted price as such prices are determined by the department pursuant to this subchapter.

     6. Operation of program. The requirements of this subsection apply to participating retail pharmacies.

     Sec. 5. 22 MRSA §2681, sub-§7, as enacted by PL 1999, c. 786, Pt. A, §3 and amended by PL 2001, c. 405, §2 and affected by §3, is repealed and the following enacted in its place:

     7. Action with regard to nonparticipating manufacturers and labelers. The names of manufacturers and labelers who do not enter into rebate agreements pursuant to this subchapter are public information. The department shall release this information to health care providers and the public. The department shall impose prior authorization requirements in the MaineCare program, as permitted by law, to the extent the department determines it is appropriate to do so in order to encourage manufacturer and labeler participation in the program and so long as the additional prior authorization requirements remain consistent with the goals of the MaineCare program and the requirements of the federal Social Security Act, Title 19.

This subsection is repealed when subsection 7-A takes effect.

     Sec. 6. 22 MRSA §2681, sub-§7-A is enacted to read:

     7-A. Action with regard to nonparticipating manufacturers and labelers. The names of manufacturers and labelers who do and do not enter into rebate agreements pursuant to this subchapter are public information. The department shall release this information to health care providers and the public on a regular basis and shall publicize participation by manufacturers and labelers that is of particular benefit to the public. The department shall impose prior authorization requirements in the MaineCare program, as permitted by law, to the extent the department determines it is appropriate to do so in order to encourage manufacturer and labeler participation in the program and so long as the additional prior authorization requirements remain consistent with the goals of the MaineCare program and the requirements of the federal Social Security Act, Title 19.

This subsection takes effect on the date that the department begins offering prescription drug benefits under the program.

     Sec. 7. 22 MRSA §2681, sub-§8, as enacted by PL 1999, c. 786, Pt. A, §3, is repealed.

     Sec. 8. 22 MRSA §2681, sub-§9, as amended by PL 2001, c. 358, Pt. Q, §6, is amended to read:

     9. Dedicated fund. The Maine Rx Plus Dedicated Fund, referred to in this section as the "fund," is established to receive revenue from manufacturers and labelers who pay rebates as provided in subsection 4 and any appropriations or allocations designated for the fund. The purposes of the fund are to: reimburse retail pharmacies for discounted prices provided to qualified residents pursuant to subsection 5; to reimburse the department for contracted services including pharmacy claims processing fees, administrative and associated computer costs, professional fees paid to participating retail pharmacies and other reasonable program costs; and to benefit the elderly low-cost drug program under section 254. The fund is a nonlapsing dedicated fund. Interest on fund balances accrues to the fund. Surplus funds in the fund must be used for the benefit of the program. Notwithstanding Title 5, section 1585, surplus funds may also be transferred to the elderly low-cost drug program established under section 254.

     Sec. 9. 22 MRSA §2682, as amended by PL 2001, c. 471, Pt. E, §§5 to 7 and affected by §8, is further amended by repealing the section headnote and enacting the following in its place:

§2682.   Display of Maine Rx Plus Program participation information

     Sec. 10. 22 MRSA §2693, sub-§1, ¶¶A and B, as enacted by PL 1999, c. 786, Pt. A, §3, are amended to read:

     Sec. 11. PL 2001, c. 405, §3 is amended to read:

     Sec. 3. Effective date. This Act takes effect on the date that the Department of Human Services begins offering prescription drug benefits under the Maine Rx Plus Program as defined established in the Maine Revised Statutes, Title 22, section 2681.

     Sec. 12. Transfer for Maine Rx Plus Program. Notwithstanding any other provision of law, the State Controller shall transfer $800,000 in fiscal year 2003-04 and $2,000,000 in fiscal year 2004-05 from the unappropriated surplus of the General Fund to the Maine Rx, Other Special Revenue Funds account within the Department of Human Services. These funds must be used for the implementation and operations of the Maine Rx Plus Program.

Effective September 13, 2003, unless otherwise indicated.

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