HB 134-MEDICAID PAYMENT FOR MEDISET PRESCRIPTION  8:12:16 AM CHAIR HIGGINS announced that the next order of business would be HOUSE BILL NO. 134, "An Act requiring Medicaid payment for scheduled unit dose prescription drug packaging and dispensing services for specified recipients." [In front of the committee was the proposed committee substitute (CS) for HB 134, labeled 28-LS0303\R, Mischel, 4/1/13, which had been adopted as the working draft on April 1, 2013] 8:12:22 AM REPRESENTATIVE KELLER moved to adopt the proposed committee substitute (CS) for HB 134, labeled 28-LS0303\T, Mischel, 2/27/14, as the working draft. There being no objection, it was so ordered. REPRESENTATIVE MIA COSTELLO, Alaska State Legislature, asked that her staff present the proposed changes to the bill. CHARLES GUINCHARD, Staff, Representative Mia Costello, Alaska State Legislature, explained that the proposed CS had three significant changes. In working with Department of Health and Social Services, parts of the proposed bill had been re-arranged to lower costs without changing any of the intent. The second change was the deletion of any reference to DHSS paying for the shipping costs of medication. He explained that the third major change was for DHSS to adopt new regulations for pharmacy reimbursement, which would be "right in line with what this bill is asking." He pointed out that the fiscal note for the proposed bill was zero. [Included in members' packets] MR. GUINCHARD directed attention to the Sectional summary provided by the Division of Legal and Research Services, dated March 5, 2014. [Included in members' packets] Section 1 required Department of Health and Social Services to establish an additional fee under the Medicaid program, to be paid to a qualified pharmacy for dispensing services for prescriptions that require medication compliance packaging into scheduled unit doses for specified Medicaid recipients, and it described specialized dispensary and delivery services which were covered. Section 2 provided a contingent effective date, as any change to a Medicaid program needed to be approved by the federal government. Section 3 would establish the effective date. 8:17:14 AM REPRESENTATIVE SEATON asked to confirm that it was no longer necessary for 75 percent of the pharmacy's business to be mediset. MR. GUINCHARD replied that, although the 75 percent was in regulation as a DHSS definition for pharmacies eligible to receive reimbursement, it was not in statute. He directed attention to the proposed bill, page 1, line 13, which defined who was qualified to receive the dispensing fee. He pointed to page 2, lines 3 - 12, which listed five criteria for establishing a mediset. He stated that the bill determined that a pharmacy capable of providing these five criteria was eligible to receive the reimbursement. 8:19:19 AM REPRESENTATIVE TARR directed attention to the fiscal note and asked for clarification that the change from $750,000 to zero had resulted from removal of the travel component. She asked if the recipient was now responsible for this cost. MR. GUINCHARD pointed to two significant changes in the proposed bill which addressed the fiscal note. The first change was the deletion of the transportation mandate to which she had referred, although this was not responsible for the entire reduction of the fiscal note. He stated that rearrangement of the proposed bill was also responsible for a significant reduction to the fiscal note. He noted that the criteria on page 2, lines 3 - 12, in previous versions of the bill, had created concern with DHSS that the proposed bill would require establishment of separate fees for each of the criteria. Reorganization of the proposed bill into Version T had now clarified that only one fee would be established. 8:21:43 AM MARGARET BRODIE, Director, Director's Office, Division of Health Care Services, Department of Health and Social Services, explained that removal of the transportation mandate had eliminated the need for a survey to determine a new dispensing fee, which had included delivery of the pharmaceuticals; hence, the zero fiscal note. She said that the dispensing fee and the mediset fee included delivery of the pharmaceuticals. REPRESENTATIVE TARR asked to clarify that transportation was still included. MS. BRODIE stated that this was correct. 8:22:47 AM CHAIR HIGGINS closed public testimony. 8:22:55 AM REPRESENTATIVE KELLER moved to report CSHB 134, Version 28- LS0303\T, Mischel, 2/27/14, out of committee with individual recommendations and the accompanying zero fiscal note. There being no objection, CSHB 134(HSS) was moved from the House Health and Social Services Standing Committee.