Iowa Pharmacy Association's Legislative Alert Network

Friday, March 14, 2008

PBM Update

The House and Senate Government Oversight Committees held a joint subcommittee meeting Mondayon HSB 669 and SSB 3149regardingPBM Regulation.IPA members Steve Firman, Bob Stessman, and Helen Eddy testified before legislators along with IPA's CEO&Executive Vice President, Tom Temple, and Legal Counsel, Bill Wimmer in support of moving to a 15 day reimbursement standard. Legislators also heard from PBMs, PHARMA, the State Attorney General's Office, and the State Insurance Commissioner. IPA continues to work with the Division of Insurance on rules to address prompt pay, as mandated in SF 512 which passed last legislative session. Another public hearing on those draft rules is scheduled for next Friday, March 21st.

 

Voted out of the House

 

HF 2265 Pseudoephedrine Tracking

This bill will now be sent to the Senate for debate.

 

HF 2539 Health Care Reform

Bills of Interest in the House 

 

HSB 669 Pharmacy Benefit Managers

Companion Bill to SSB 3149. 

This bill requires PBMs to reimburse pharmacies within 15 days for clean claims effective July 1, 2008.  This bill also includes the transparency language that did not pass in SF 512.  This section would require a PBM to disclose its contracts with drug manufacturers and an aggregate amount of rebates. As mandated with the passage of SF 512 last year, IPA has been working with the Division of Insurance to draft rules relating to prompt pay, auditing, and adjudication of claims.  IPA does not feel at this time that the proposed rules will adequately address the issue of prompt pay and has moved forward this legislation.  We will continue to work with the Insurance Commissioner to reach a compromise while we pursue passage of this legislation.

Government Oversight Committee. 

IPA supports this bill.

 

SF 607 Medicaid Provider Increase

This bill passed the Senate in 2007.

This bill appropriates a 1% increase to providers.  This bill was introduced in 2007 and passed the Senate.  This week the bill was introduced in the House and referred to the Appropriations Committee.  

IPA supports this bill.

 

HF 2128 Insurance Mandate Commission
This bill creates a state health insurance mandate commission consisting of 14 specified 
members and chaired by the Commissioner of Insurance or the Commissioner's designee.
This bill requires the Commission to make findings on any bill with a state mandate for 
health insurance before approval by a legislative committee and requires the LSA to make 
the initial determination that the bill includes a mandated benefit.
IPA is monitoring this bill.
 

HF 2155 Department of Human Services Reimbursement

This bill appropriates a 3% increase to service providers reimbursed by the Department of

Human Services including pharmacy dispensing fees.

Appropriations Committee. 

IPA supports this bill.

 

HF 2166 Tech Check Tech

Passed both the House and Senate.  Awaits Governor Culver's signature.

This bill defines a tech check tech program and directs the Board of Pharmacy to adopt rules relating to the program.  This bill also authorizes a pharmacist intern to transfer and receive the transfer of a prescription order from a pharmacist or pharmacist intern.

This is a Board of Pharmacy initiative and IPA supports this bill.

 

HF 2265 Pseudoephedrine Tracking

Successor to HSB 522.  This bill passed the House Chamber.

This bill limits sales of pseudoephedrine to 3,600 mg within a 24 hour period.  This bill requires the purchaser of a pseudoephedrine product to present a driver's license or other state issued photo ID prior to purchase and sign an electronic logbook.  If an electronic logbook is unavailable, the pharmacy must keep an alternative record that complies with rules adopted by the Board of Pharmacy.  This bill requires a pharmacy to keep electronic logbook records for 24 months. This bill also directs the Board of Pharmacy to implement a statewide real time central repository to track pseudoephedrine product sales at pharmacies and requires pharmacies to report all sales electronically to the repository.

IPA is monitoring this bill.

HF 2374 Office of Drug Control and Policy Appropriation

This bill requires that the appropriation to the Office of Drug Control Policy for 2008 for multi-jurisdictional drug enforcement programs not be reduced if a federal appropriation is increased. Appropriates $2.4 million for such programs in 2009. 

Appropriations Committee. 

IPA is monitoring this bill.

 

HF 2486 Department of Public Health Bill
Companion bill to SF 2177 and successor to HSB 629.  

This bill is divided into several divisions relating to activities and regulations by the Department of

Public Health.  This bill strikes the responsibility for general supervision over the administration of

the housing law and giving aid to local authorities to enforce the law, makes the brain injury 
diagnosis used for the cost-share component of the program the same as the Medicaid waiver 
for persons with brain injury, allows the DPH to enter into agreements with local boards of health 
for inspection and enforcement activities for a variety of reasons, allows the use of the USDA 
program for accreditation of mammography machines and allows a general authorization for the 
machines, allows a minor to give consent for medical care for sexually transmitted diseases and 
requires an inquiry by a medical examiner in cases of non-natural death.  
IPA is monitoring this bill.
 

HF 2539 Health Care Reform

Successor to HSB 757.  This bill passed the House Chamber.
This bill lays the framework for the legislature to extend health care coverage to all Iowans with
the priority being for children, and for coverage to be extended to children in families at 300% of
the poverty level, if the federal government authorizes it.  This bill creates the Iowa Health
Information Technology System and requires health care professionals to use patient identifiers
and continuity of care records specified by the Commission by July, 2010.   This bill requires
health insurance to allow a continuation of coverage for an unmarried dependent child of an
insured, until the dependent is 25 years old or while the dependent is a full-time college student
and requires an insurance carrier that has small group coverage to establish additional groups of
small employers and to require the insurance carrier to offer health insurance coverage to bona fide

associations.  This bill also requires coverage for pre-existing conditions when a person shifts from a

group policy to an individual policy.  This bill creates a Medical Homes Commission and  defines a

medical home to include pharmacists as providers. 
IPA is monitoring this bill.

 

HF 2604 Medicaid Information

Companion bill to SF 2334 and successor to HSB 745.
This bill complies with the Deficit Reduction Act of 2005 required changes for third party payment
of health care when the third party was legally responsible to pay.  This bill allows the sharing of
information on health care coverage between entities with the information and the Iowa Medicaid
Enterprise to find out if a Medicaid recipient has other coverage and requires Medicaid recipients
to help the DHS identify third parties which may be responsible for coverage.
IPA is monitoring this bill.

 

HF 2605 Department of Public Health Licensing Bill

Companion bill to SF 2338 and successor to HSB 677.
This bill allows boards to consider any criminal conviction of an applicant and makes changes
to membership on several boards.  This bill allows the disclosure of an applicant's criminal
history and gives individual boards the responsibility for health personal statistics for administering
examinations and for reciprocity.  This bill moves the regulation of speech pathologists and audiologists
into its own Code chapter, combines the licensing of physicians and surgeons and osteopathic
physicians and surgeons into a single licensing chapter, creates a pool of alternate members for t
he board of medicine to act as substitutes in hearing and allows a
disciplinary hearing to be open to the public only at the discretion of the licensee.   
IPA is monitoring this bill.

 

Voted out of the Senate

HF 2166 Tech Check Tech

This bill will now be sent to Governor Culver for his signature.

 

SF 2338 Department of Public Health Licensing

Bills of Interest in the Senate

SSB 3149 Pharmacy Benefit Managers

Companion Bill to HSB 669. This bill is funnel proof.

This bill requires PBMs to reimburse pharmacies within 15 days for clean claims effective July 1, 2008.  This bill also includes the transparency language that did not pass in SF 512.  This section would require a PBM to disclose its contracts with drug manufacturers and an aggregate amount of rebates. As mandated with the passage of SF 512 last year, IPA has been working with the Division of Insurance to draft rules relating to prompt pay, auditing, and adjudication of claims.  IPA does not feel at this time that the proposed rules will adequately address the issue of prompt pay and has moved forward this legislation.  We will continue to work with the Insurance Commissioner to reach a compromise while we pursue passage of this legislation.

Government Oversight Committee.

IPA supports this bill.

 

SF 2177 Department of Public Health Bill

Successor to SSB 3137 and companion bill to HSB 629.

This bill is divided into several divisions relating to activities and regulations by the Department of Public Health.  This bill strikes the responsibility for general supervision over the administration of the housing law and giving aid to local authorities to enforce the law, makes the brain injury diagnosis used for the cost-share component of the program the same as the Medicaid waiver for persons with brain injury, allows the DPH to enter into agreements with local boards of health for inspection and enforcement activities for a variety of reasons, allows the use of the USDA program for accreditation of mammography machines and allows a general authorization for the machines, allows a minor to give consent for medical care for sexually transmitted diseases and requires an inquiry by a medical examiner in cases of non-natural death. 

IPA is monitoring this bill.

 

SF 2319 Health Communities and Fitness

Successor to SSB 3225.

This bill directs the Department of Public Health to establish an Iowa Healthy Communities Initiative Grant program to assist communities in promoting healthy lifestyles.  This bill establishes the Governor's Council on Physical Fitness and sets the membership of the council. This bill also requires an initial draft of the plan to the Legislature and the Governor by December 2008. 

IPA is monitoring this bill.

 

SF 2334 Medicaid Information

Successor to SSB 3196 and companion bill to HF 2604. 

This bill complies with the Deficit Reduction Act of 2005 required changes for third party payment of health care when the third party was legally responsible to pay.  This bill allows the sharing of information on health care coverage between entities with the information and the Iowa Medicaid Enterprise to find out if a Medicaid recipient has other coverage and requires Medicaid recipients to help the DHS identify third parties which may be responsible for coverage.

IPA is monitoring this bill.

 

SF 2338 Department of Public Health Licensing

Successor to SSB 3182 and companion bill to HF 2605.  This bill passed the Senate Chamber. This bill allows boards to consider any criminal conviction of an applicant and makes changes to membership on several boards.  This bill allows the disclosure of an applicant's criminal history and gives individual boards the responsibility for health personal statistics for administering examinations and for reciprocity.  This bill moves the regulation of speech pathologists and audiologists into its own Code chapter, combines the licensing of physicians and surgeons and osteopathic physicians and surgeons into a single licensing chapter, creates a pool of alternate members for the board of medicine to act as substitutes in hearing and allows a disciplinary hearing to be open to the public only at the discretion of the licensee.

IPA is monitoring this bill.

SF 2370 Health Care Workforce

Successor to SSB 3186.

This bill is based on the recommendations of the co-chairs of the Commission on Affordable Health Care. This bill establishes a Health Care Professional Recruitment Program and revolving fund.  It creates a loan forgiveness program, for students who practice health care in underserved areas, and a rural community loan forgiveness program administered by the College Student Aid Commission.  Requires rural communities to match state funds on a $1 to $1 basis.  Requires an eligible student to be a resident of Iowa, enrolled full-time at a medical school or other health care professional school, and agree to practice in an undeserved area for a time served by the College Student Aid Commission and allows a current health care professional who graduated from an Iowa school to use the program.  This bill creates an income tax credit for qualified health care providers of up to $20,000, available to health care providers for whom there are not enough to meet population needs, as determined by the DPH.  This bill also directs the DHS to adopt rules for paying Medicaid, HAWK-I, and IowaCare providers for using telemedicine programs, and to seek any necessary waivers.  

Appropriations Committee. 

IPA is monitoring this bill.

 

SF 2390 Iowa Health Care Coverage

Successor to SSB 3140.

This bill is based on the recommendations of the Commission on Affordable Health Care for Families and Small Businesses and sets the goal of becoming the first state in the nation to provide insurance coverage to all children.  This bill contains 11 divisions.

This bill uses the existing Iowa Comprehensive Health Insurance Association to require all children have coverage as funding becomes available and allows dependents up to 25 years old to have continued coverage on their parents insurance.  This bill creates a Medical Home Commission and defines Medical Home to include pharmacists as providers.  This bill creates a Prevention and Chronic Care Management Advisory Council to assist the Director of Public Health to establish a state initiative.  This bill also creates an interoperable health information technology system and requires health care professionals to use patient identifiers and continuity of care records specified by the Commission by July, 2010.  This bill creates a new office of Health Care Quality, Cost Containment, and Consumer Information to help implement cost containment strategies.  This bill also sets out health care transparency reporting requirements.

IPA is monitoring this bill.