05/13/2019 02:30 PM House FINANCE

CS FOR SENATE BILL NO. 44(FIN)                                                                                                
                                                                                                                                
     "An Act relating to the prescription of drugs by a                                                                         
     physician assistant without physical examination; and                                                                      
     providing for an effective date."                                                                                          
                                                                                                                                
2:30:39 PM                                                                                                                    
                                                                                                                                
Vice-Chair Johnston MOVED to ADOPT proposed committee                                                                           
substitute for CSSB 44(FIN), Work Draft 31-LS0019\O(Fisher                                                                      
5/9/19) (copy on file).                                                                                                         
                                                                                                                                
There being NO OBJECTION, it was so ordered.                                                                                    
                                                                                                                                
Co-Chair Wilson invited Ms. Carpenter to discuss the                                                                            
changes to the committee substitute.                                                                                            
                                                                                                                                
2:31:21 PM                                                                                                                    
                                                                                                                                
HEATHER CARPENTER,  DEPUTY DIRECTOR,  COMMISSIONER'S OFFICE,                                                                    
DEPARTMENT  OF  HEALTH  AND SOCIAL  SERVICES,  reviewed  the                                                                    
changes  in  the committee  substitute.  She  read from  the                                                                    
Explanation of Changes (copy on file) document:                                                                                 
                                                                                                                                
                                                                                                                                
     Page  1,  lines 2     3:    Expands  the title  of  the                                                                    
     legislation to include  "relating to prescription drugs                                                                    
     under the medical assistance program;"                                                                                     
                                                                                                                                
     Page 3, line 14    Page 5, line 4:   Adds a new section                                                                    
     5  that amends  AS  47.05.012 to  include the  Medicaid                                                                    
     Preferred Drug List  and prior authorization medication                                                                    
     list   to  material   incorporated  by   reference  via                                                                    
     regulation.                                                                                                                
                                                                                                                                
     (This  means  the  lists  can  be  adopted  after  each                                                                    
     Pharmacy  & Therapeutics  and  Drug Utilization  Review                                                                    
     Committee  meetings  occur  each  September,  November,                                                                    
     January  and April.  Changes will  be publicly  noticed                                                                    
     stating the  new list replaces  the old list.   The new                                                                    
     adoption of changes  will take about 60 days.   This is                                                                    
     a common practice for lists,  codes, manuals or certain                                                                    
     guidelines  that   are  updated  periodically   from  a                                                                    
     previous  version.     Examples  include   the  federal                                                                    
     poverty   guidelines  for   the   state,  the   current                                                                    
     procedural terminology for  physicians published by the                                                                    
     American  Medical Association,  and the  consumer price                                                                    
     index.)                                                                                                                    
                                                                                                                                
     Page  4, lines  5    13:   Adds  a new  Section 6  that                                                                    
     amends  AS  47.07.065  to  require  the  Department  to                                                                    
     capture   cost  savings   and   cost  containment   for                                                                    
     prescribed   drugs  by   adopting   and  updating   the                                                                    
     preferred  drug   list  and  the   prior  authorization                                                                    
     medications  list.   Provides for  a definition  of the                                                                    
     preferred drug  list and lists  specific types  of cost                                                                    
     savings and cost containment  measures for the pharmacy                                                                    
     program that can be utilized.                                                                                              
                                                                                                                                
     Page 5,  Line 20: Applies the  immediate effective date                                                                    
     to Sections 5 7.                                                                                                           
                                                                                                                                
2:33:36 PM                                                                                                                    
                                                                                                                                
Ms.  Carpenter relayed  that the  Department  of Health  and                                                                    
Social Services  (DHSS) submitted  a draft fiscal  note that                                                                    
indicated a savings  of $1 million in FY 2020  and a savings                                                                    
of $2  million each year from  FY 2021 through FY  2025. She                                                                    
reminded the committee that the  FY 20 savings were included                                                                    
in the  governors  proposed budget. The  governor proposed a                                                                    
$225  million general  fund (GF)  reduction in  Medicaid and                                                                    
the  savings would  help meet  the  targeted reduction.  She                                                                    
qualified that the amount was  not included in the Phase One                                                                    
Medicaid  savings  reduction and  was  not  included in  the                                                                    
budget  numbers being  considered  by  the operating  budget                                                                    
Conference Committee.                                                                                                           
                                                                                                                                
2:34:27 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:37:42 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
2:38:28 PM                                                                                                                    
                                                                                                                                
Vice-Chair Johnston  MOVED to report HCSCSSB  44(FIN) out of                                                                    
Committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal notes.                                                                                                      
                                                                                                                                
There being NO OBJECTION, it was so ordered.                                                                                    
                                                                                                                                
[Note:  Neal  Foster  was  not present  when  the  bill  was                                                                    
reported out].                                                                                                                  
                                                                                                                                
HCSCSSB 44(FIN) was REPORTED out  of committee with five "do                                                                    
pass"   recommendations   and   five   "no   recommendation"                                                                    
recommendations and with  one new fiscal impact  note by the                                                                    
Department of Health and Social  Services and one previously                                                                    
published fiscal impact note: FN1 (CED).