HB 134-MEDICAID PAYMENT FOR MEDISET PRESCRIPTION  1:31:25 PM CHAIR STEDMAN announced the consideration of HB 134. [CSHB 134(HSS) was before the committee.]He said it was the first hearing of the bill. The intent is to have the sponsor introduce the bill, take public testimony, and set the bill aside for further review. 1:31:50 PM CHARLES GUINCHARD, Staff, Representative Mia Castello, Alaska State Legislature, Juneau, Alaska, presented HB 134 on behalf of the sponsor. He related that the bill is the sponsor's intent to memorialize in statute a program that exists at the level of regulation. The goal of the mediset program is to save the state long-term costs by helping the most vulnerable Alaskans stay compliant with their medications. He referred to a legislative research brief in members' packets that shows cost of care decreases when patients are compliant with their medication. Medication management services such as mediset helps them stay compliant. He listed the support for the bill from the Alaska Mental Health Board, the Chugiak-Eagle River Senior Center, the Alaska Commission on Aging, the Alaska Mental Health Trust Authority, the Alaska Nurses Association, the Governor's Council on Disabilities, Hope Community Resources, the Alaska Pharmacist Association, and various assisted living homes and pharmacies. 1:33:56 PM MR. GUINCHARD showed a video relating to mediset prescriptions and who they apply to. It described the difficulties the frail and elderly have with taking prescriptions and how mediset assists them. It explained some of the costs saved by the dispensing services. 1:38:35 PM MR. GUINCHARD explained the sections of the bill. In Section 1 (a) the Department of Health and Social Services (DHSS) establishes the fee to pay a qualified pharmacy for a prescription that requires scheduled units of use to a qualified medical assistance recipient. He pointed out on line 9, "for a prescription that requires" is the language that will result in a physician needing to physically write "Mediset" on the prescription. He related that in Section 1 (b), the bill addresses pharmacies that are qualified to dispense with five qualifiers - the cost drivers when preparing and dispensing a mediset. These five cost drivers will be incorporated into one mediset fee determined by DHSS. He said that Section 1 (c) addresses who under Medicaid will qualify for a mediset. It was language added at the department's request so that the bill will not expand nor contract the scope of who is currently eligible. Section 1 (d) consists of two definitions; "medication compliance packaging" and "units of use." He related that Sections 2 and 3 are a complicated effective date. Because of any change to the state's Medicaid program requires federal approval, Section 2 specifies that. Section 3 says when DHSS has received approval, the statute will come into effect. CHAIR STEDMAN noted one zero fiscal note from Department of Health and Social Services (DHSS). He opened public testimony. 1:43:23 PM GERALD BROWN, Pharmacist, Fairbanks, Alaska, testified in opposition to several provisions in HB 134. He noted a restriction included in the bill that says 75 percent of a pharmacy's business must be medisets in order to receive payment for unit-dosing prescriptions for individuals. He said his pharmacy does not have that ratio, yet does over 900 bubble packs per month. He maintained that the ratio is not reasonable and all pharmacies should be eligible to receive the unit dosing fee. As written, the bill is limited to certain pharmacies in Anchorage. MR. BROWN addressed the dispensing fee, which was last established on 50 cents per unit. He said it takes $3 to do so now. He requested that it be equitable to the pharmacy costs in preparing the units and keeping records. He emphasized that the mediset service is much needed. It is important that the fees cover the actual costs. CHAIR STEDMAN noted a forthcoming committee substitute that would address those issues. MR. BROWN suggested the bill provisions should be open to all pharmacies. 1:47:42 PM ARLENE BRISCOE, Registered Nurse, Alaska Nurses Association, Anchorage, Alaska, testified in support of HB 134. She shared that many of her patients suffer from severe mental illness which precludes them from remembering to take their medications. She stressed that they need the assistance this bill provides. She voiced concern about the department's reimbursement policy for pharmacies - that 75 percent of their business must be providing medisets in order to qualify. She noted that at her hospital patients often have to be kept longer because they are waiting for mediset medications, which is costing Medicaid and other insurance plans money. She stressed that the program should be available to all pharmacies in the state, including rural pharmacies. 1:50:24 PM BERRY CHRISTENSEN, Co-Chair, Alaska Pharmacists Association - Legislative Committee, Ketchikan, Alaska, testified in support of the concept of mediset, but in opposition to limiting the number of pharmacies who can quality for the dosage unit fee. 1:51:26 PM CHAIR STEDMAN closed public testimony. CHAIR STEDMAN held HB 134 in committee.