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).