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HOUSE BILL NO. 441

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Daily Data Tracking History

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H0441........................................................by MR. SPEAKER
              Requested by: Department of Health and Welfare
PHARMACY REIMBURSEMENTS - Amends existing law to allow the Department of
Health and Welfare to reduce pharmacy reimbursement rates in a manner
consistent with amounts paid by other prudent purchasers.

01/12    House intro - 1st rdg - to printing
01/12    Rpt prt - to Health/Wel

Bill Text

H0441

                                                                        
 ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
Fifty-fourth Legislature                 Second Regular Session - 1998
                                                                        

                             IN THE HOUSE OF REPRESENTATIVES

                                    HOUSE BILL NO. 441

                                      BY MR. SPEAKER
                      Requested by: Department of Health and Welfare

 1                                        AN ACT
 2    RELATING TO PHARMACY REIMBURSEMENT; AMENDING SECTION 56-209g, IDAHO  CODE,  TO
 3        AUTHORIZE  THE  DEPARTMENT  OF HEALTH AND WELFARE TO REDUCE PHARMACY REIM-
 4        BURSEMENT LEVELS CONSISTENT WITH AMOUNTS PAID BY OTHER PRUDENT PURCHASERS.

 5    Be It Enacted by the Legislature of the State of Idaho:

 6        SECTION 1.  That Section 56-209g, Idaho Code, be, and the same  is  hereby
 7    amended to read as follows:

 8        56-209g.  PHARMACY  REIMBURSEMENT.    From  January  1, 1991, through
 9    December 31, 1994, pursuant to federal action, a moratorium  on  reduction  of
10    pharmacy reimbursement levels for medicaid under title XIX of the social secu-
11    rity  act has been in effect   Medicaid pharmacy reimbursement lev-
12    els are a combination of the cost of the  drug  and  a  dispensing  fee  which
13    includes  such pharmaceutical care services as counseling, obtaining a patient
14    history, documentation, and dispensing the drug . From and after January
15    1, 1995,  through June 30, 1998,  it shall be  the  policy  of  the
16    state of Idaho that there be no reduction of pharmacy reimbursement levels for
17    medicaid  under  title  XIX  of the social security act except as necessary to
18    comply with federal regulations, 42 CFR 447.331  through  447.334,  as  imple-
19    mented  in  the  state  of Idaho.  Effective July 1, 1998, pharmacy reim-
20    bursement levels may be reduced  by  the  department  to  be  consistent  with
21    amounts paid by other prudent purchasers. 

Statement of Purpose / Fiscal Impact

    STATEMENT OF PURPOSE 
    RS07300
    
    
    Consistent with the Governor's Medicaid Reform initiatives, the purpose of this legislation 
    is to give the state flexibility to adjust reimbursement levels for prescription drugs 
    purchased in connection with the state's medical assistance program to levels paid by 
    other prudent purchasers of such items and services. Current state law prohibits the 
    department from reducing payment levels except where federal upper payment limits are 
    exceeded. This legislation will allow the department the flexibility to consider both 
    components of the reimbursement level, the dispensing fee and the cost of the drug, in 
    determining appropriate payment levels consistent with amounts paid by other cost 
    prudent purchasers.
    
                               FISCAL IMPACT
    
    The legislation is expected to result in savings to the state of approximately $1.5 million.
    
    CONTACT
    Name: Kathleen Allyn
    Agency: Department of Health and Welfare
    Phone: 334-5747
    Statement of Purpose/Fiscal Impact
    
    H 441