3.__Appeals.__A determination that a particular drug is subject to prior authorization constitutes final agency action within the meaning of the Maine Administrative Procedure Act and is subject to judicial review under the Maine Administrative Procedure Act.__Persons entitled to appeal a decision of the committee to subject a particular drug to prior authorization are limited to:

A.__MaineCare recipients who were being prescribed the drug at the time of the committee's decision;

B.__Health care providers who had prescribed the drug at the time of the committee's decision; and

C.__The manufacturer of the drug.

4.__Rules.__The department shall adopt rules to implement this section.__Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

SUMMARY

This bill establishes the Drug Utilization Review Committee. The committee makes determinations regarding which prescription and over-the-counter drugs are subject to prior authorization under the MaineCare program. The bill requires public notice of committee meetings to be given, and provides that committee meetings are public proceedings and committee documents are public records for purposes of the laws governing freedom of access. It provides that members of the public must be granted a reasonable opportunity to address the committee and requires the committee to issue written findings that describe the basis for its decisions. It also provides that a 2/3 vote of the committee is required to add or delete a drug from the list of drugs that require prior authorization and that the decisions of the committee are final agency action for purposes of the Maine Administrative Procedure Act.