Maryland Department of Health and Prescription Drug Affordability Board - Managed Care Organizations and Prescription Drug Claims - Study
Impact
If enacted, HB 382 will establish clearer guidelines regarding reimbursement levels that pharmacy benefits managers must adhere to. This will likely enable better financial conditions for retail pharmacies, thereby potentially encouraging more pharmacies to participate in providing services under the Maryland Medical Assistance Program. Furthermore, the bill instructs the Maryland Department of Health and the Prescription Drug Affordability Board to conduct a comprehensive study regarding past reimbursement practices and their financial impacts on pharmacies in 2021 and 2022.
Summary
House Bill 382 focuses on the regulation of pharmacy benefits administration under the Maryland Medical Assistance Program, specifically concerning reimbursement rates for pharmacies. The bill mandates that reimbursement levels for drug products must be at least equal to the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee, in order to enhance fairness and consistency in drug pricing. This initiative aims to improve accessibility and affordability of prescription medications for Maryland residents, particularly through managed care organizations.
Sentiment
The sentiment surrounding HB 382 appears to be generally positive among legislators focused on healthcare affordability and access. Supporters of the bill argue that it is necessary to alleviate financial strains on pharmacies, which have been adversely affected by previous reimbursement policies. Nonetheless, the bill does face scrutiny from some stakeholders concerned about the implications for managed care organizations and the potential costs this may impose on state healthcare programs.
Contention
One notable point of contention revolves around the financial implications for managed care organizations, which may be tasked with adjusting to new reimbursement rates that could affect their overall budgets and operations. Opponents may argue that this could lead to increases in premiums for consumers or strain on state resources, as the bill seeks to enforce minimum reimbursement requirements that may not have been financially feasible prior. Additionally, the bill's impact on mail-order pharmacies — which are exempt from certain provisions — raises questions regarding equitable access to pharmacy services across different types of providers.
Prescription Drug Affordability Board - Authority for Upper Payment Limits and Funding (The Lowering Prescription Drug Costs For All Marylanders Now Act)
Prescription Drug Affordability Board - Authority for Upper Payment Limits and Funding (Lowering Prescription Drug Costs for All Marylanders Act of 2024)
Enacting the prescription drug cost and affordability review act to establish the prescription drug pricing board and prescription drug affordability stakeholder council to review the cost of prescription medications and establish upper payment limits for certain prescription drugs.
State Board of Pharmacy - Accessible Prescription Labels, Bag Tags, and Medical Guides for Blind, Visually Impaired, and Print Disabled Individuals - Regulations