HLS 17RS-1138 REENGROSSED
2017 Regular Session
HOUSE BILL NO. 306
BY REPRESENTATIVE JOHNSON
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
MEDICAID: Provides relative to pharmacy reimbursement by managed care organizations
1 AN ACT
2To amend and reenact R.S. 46:460.36(D) and to repeal R.S. 46:460.36(B), (C), and (E),
3 relative to Medicaid managed care pharmacy reimbursements; to provide for the base
4 of reimbursement for prescription drugs; to repeal provisions regarding ingredient
5 cost reimbursement; to repeal requirements for a dispute process; to repeal cost
6 provisions; and to provide for related matters.
7Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 46:460.36(D) is hereby amended and reenacted to read as follows:
9 ยง460.36. Pharmacy reimbursement by managed care organizations
10 * * *
11 D. After June 15, 2016, no No managed care organization shall pay a local
12 pharmacy a per-prescription reimbursement at a rate less than the legacy Medicaid
13 rate. unless its contract with the department provides for a reimbursement dispute
14 process as described in Subsection C of this Section.
15 Section 2. R.S. 46:460.36(B), (C), and (E) are hereby repealed in their entirety.
16 Section 3. This Act shall become effective on October 1, 2017.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 17RS-1138 REENGROSSED
HB NO. 306
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 306 Reengrossed 2017 Regular Session Johnson
Abstract: Requires the base of reimbursement by managed care organizations for
prescription drugs to be at least equal to the legacy Medicaid rate.
Present law prohibits a managed care organization (MCO) from paying a local pharmacy a
per-prescription reimbursement at a rate less than the legacy Medicaid rate unless its contract
with the La. Dept. of Health (LDH) provides for a reimbursement dispute process.
Proposed law removes the option to include a reimbursement dispute process to allow a
reimbursement rate less than the legacy Medicaid rate.
Present law authorizes an MCO to negotiate the ingredient cost reimbursement in its
contracts with providers.
Proposed law repeals present law.
Present law requires any contract between LDH and an MCO that includes provisions for
pharmacy reimbursement to provide for a reimbursement dispute process for local
pharmacies.
Proposed law repeals present law.
Present law requires the full cost of implementing and performing the provisions of present
law to be the responsibility of LDH through a reallocation of existing budget resources and
not through additional appropriations.
Proposed law repeals present law.
Effective October 1, 2017.
(Amends R.S. 46:460.36(D); Repeals R.S. 46:460.36(B), (C), and (E))
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Health and Welfare to
the original bill:
1. Repeal authorization for an MCO to negotiate the ingredient cost reimbursement
with providers.
2. Repeal the requirement that a contract between LDH and an MCO provide for
a reimbursement dispute process for local pharmacies.
3. Repeal the requirement for the full cost of implementing present law to be the
responsibility of LDH through a reallocation of existing budget resources.
4. Change the effective date of the Act from effective upon signature of the
governor to July 1, 2017.
5. Make technical changes.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 17RS-1138 REENGROSSED
HB NO. 306
The House Floor Amendments to the engrossed bill:
1. Change the effective date from July 1, 2017, to October 1, 2017.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.