Provides relative to the Medicaid prescription drug benefit program. (8/1/19) (EN SEE FISC NOTE GF EX See Note)
Impact
With SB239, Louisiana expects to reduce expenses associated with drug prescriptions while ensuring that patients receive adequate care. By removing pharmacy management from third-party organizations, patients may have better access to necessary medications without the additional bureaucratic hurdles. This legislation is designed to adopt best practices from other states that have successfully removed pharmacy services from managed care contracts, thus inspiring the Louisiana Department of Health to strategize effective management of its Medicaid prescription drug benefit program following enhanced standards.
Summary
Senate Bill 239 aims to amend the existing framework of Louisiana's Medicaid prescription drug benefit program. This legislation empowers the Louisiana Department of Health to assume direct responsibility over pharmacy services previously provided through Medicaid managed care organizations. A key feature of this bill is the establishment of a single preferred drug list, which intends to streamline approvals and enhance cost-effectiveness within the Medicaid system. The focus is primarily on not only improving medication adherence but also on controlling costs that arise from the current multi-layer system involving pharmacy benefit managers.
Sentiment
Overall sentiment around SB239 appears to be optimistic and supportive among legislators who believe that this bill will lead to substantial improvements in the efficacy and cost management of Medicaid's pharmacy services. However, there may be concerns from pharmacy benefit managers about potential reductions in their operational roles and financial influence within the system. Advocates for the bill emphasize its necessity for greater efficiency in drug management and increased accessibility for Medicaid recipients.
Contention
Controversial points related to SB239 involve discussions about patient steering practices and the relationship between pharmacies and pharmacy benefit managers. Opponents of the elimination of pharmacy benefit management could argue that this step might create a less competitive environment, potentially affecting pharmacies' profit margins and their ability to serve Medicaid recipients. The transition to a state-managed system also invites scrutiny regarding whether it can adequately replace the functions once served by profit-driven managers, which prompts critical dialogues over the balance of healthcare service administration.
Provides relative to prescription drug benefits of certain managed care organizations participating in the La. Medicaid coordinated care network program (RE1 INCREASE GF EX See Note)
Provides relative to Medicaid and certain managed health care organizations providing health care services to Medicaid beneficiaries. (1/1/14) (RR1 See Note)