Public Laws

123rd Legislature

First Regular Session


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Chapter 240

H.P. 383 - L.D. 499

PART RR

Sec. RR-1. 22 MRSA §254-D, sub-§4, ¶H,  as enacted by PL 2005, c. 401, Pt. A, §2, is amended to read:

H.  Payment must be denied for drugs from manufacturers that do not enter into a rebate agreement with the department.

(1) Each agreement must provide that the manufacturer make rebate payments for both the basic and supplemental components of the program to the department according to the following schedule.

(a) From October 1, 1992 to October 1, 1998, the rebate percentage is equal to the percentage recommended by the federal Center for Medicare and Medicaid Services of the manufacturer's wholesale price for the total number of dosage units of each form and strength of a prescription drug that the department reports as reimbursed to providers of prescription drugs, provided payments are not due until 30 days following the manufacturer's receipt of utilization data supplied by the department, including the number of dosage units reimbursed to providers of prescription drugs during the period for which payments are due.

(b) Beginning October 1, 1998, the department shall seek to achieve an aggregate rebate amount from all rebate agreements that is 6 percentage points higher than that required by subdivision (a), provided such rebates result in a net increase in the rebate revenue available to the elderly low-cost drug program.

(2) Upon receipt of data from the department, the manufacturer shall calculate the quarterly payment.

(a) If a discrepancy is discovered, the department may, at its expense, hire a mutually agreed-upon independent auditor to verify the manufacturer's calculation.

(b) If a discrepancy is still found, the manufacturer shall justify its calculation or make payment to the department for any additional amount due.

(c) The manufacturer may, at its expense, hire a mutually agreed-upon independent auditor to verify the accuracy of the utilization data provided by the department. If a discrepancy is discovered, the department shall justify its data or refund any excess payment to the manufacturer.

(d) If the dispute over the rebate amount is not resolved, a request for a hearing with supporting documentation must be submitted to the department's office division of administrative hearings. Failure to resolve the dispute may be cause for terminating the drug rebate agreement and denying payment to the manufacturer for any drugs.

(3) A prescription drug of a manufacturer that does not enter into an agreement pursuant to this paragraph is reimbursable only if the department determines the prescription drug is essential.

(4) All prescription drugs of a manufacturer that enters into an agreement pursuant to this paragraph that appear on the list of approved drugs under the program must be immediately available and the cost of the drugs must be reimbursed except as provided in this paragraph. The commissioner may impose prior authorization requirements on drugs under the program. If the commissioner establishes maximum retail prices for prescription drugs pursuant to section 2693, the department shall adopt rules for the program requiring the use of a drug formulary and prior authorization for the dispensing of certain drugs to be listed on a formulary.

(5) The names of manufacturers who do and do not enter into rebate agreements pursuant to this paragraph are public information. The department shall release this information to health care providers and the public on a regular basis and shall publicize participation by manufacturers that is of particular benefit to the public.

Sec. RR-2. 22 MRSA §256-A, first ¶,  as enacted by PL 2005, c. 327, §2, is amended to read:

Beginning in 2006, the Department of Labor, in conjunction with the Office of Health Data and Program Management's Office Division of Data, Research and Vital Statistics, shall compile and annually update a health care occupations report to be completed and presented to the health workforce forum established in section 257 by September 15th. The report must be posted on a publicly accessible site on the Internet maintained by the Department of Labor and provide the following information:

Sec. RR-3. 22 MRSA §256-B, sub-§3,  as enacted by PL 2005, c. 327, §2, is amended to read:

3. Submission of surveys.   All surveys conducted pursuant to subsection 1 must be submitted to the Office of Health Data and Program Management's Office Division of Data, Research and Vital Statistics for analysis, and survey data from which personally identifiable information has been eliminated must be publicly available.

Sec. RR-4. 25 MRSA §2154-A, sub-§1, ¶C,  as enacted by PL 1997, c. 468, §1 and amended by PL 2003, c. 689, Pt. B, §6, is further amended to read:

C.  The Vital Records Unit of the Office of Data Research Division of Data, Research and Vital Statistics in the Department of Health and Human Services.

Sec. RR-5. Rename Office of Data, Research and Vital Statistics program. Notwithstanding any other provision of law, the Office of Data, Research and Vital Statistics program is renamed the Division of Data, Research and Vital Statistics program.

Sec. RR-6. Rename Office of Administrative Hearings program. Notwithstanding any other provision of law, the Office of Administrative Hearings program is renamed the Division of Administrative Hearings program.

Sec. RR-7. Rename Traumatic Brain Injury program. Notwithstanding any other provision of law, the Traumatic Brain Injury program is renamed the Brain Injury program.

Office of the Revisor of Statutes
State House, Room 108
Augusta, ME 04333