While the new Affordable Health Care law provides a variety of funding
opportunities for states, one provision in the health law that could
shift billions of dollars from cash-strapped states to the federal
government. Under the National
Medicaid Drug Rebate Program created by the Omnibus Budget
Reconciliation Act of 1990, drug manufacturers are required to enter
into agreements that provide rebates for Medicaid purchased drugs,
establishing a 15% minimum level of rebates. Up until now, the rebates
were divided between the states and the federal government. But under
the new health reform law, a significant portion of the rebates will go
solely to Washington beginning this year.
Both to address the burden of prescription drug costs for consumers and
ease their own state budgets, states across the country are moving
reforms to lower the cost and increase the quality of prescription drug
decisions made by providers.
As Congress delays moving forward on the passage of comprehensive
health care reform, progressive state leaders from across the country
have been demanding passage of reform
as critical for families across the nation. But that doesn't mean they
are waiting; state leaders are moving forward, laying the groundwork
for how national changes should be implemented, and creating the
momentum for other meaningful health care reforms in their states.
Policy Overview: Require the industry to disclose information
about advertising and marketing spending, and prohibit gifts and
payments to health care practitioners from pharmaceutical and medical
Policy Overview: Regulate Pharmacy Benefits Managers (PBMs),
who act as middlemen between drug manufacturers and public and private
health plans, negotiating prices for prescription drugs. The PBM
industry is highly corruptible
and lax oversight of PBM practices has resulted in ethical lapses and
instances of PBMs pocketing discounts they negotiated for health plans,
rather than forwarding discounts through to clients. Require
transparency, a fiduciary relationship, and annual audits of all PBMs
to ensure that the full value of negotiated discounts, rebates, or
other financial considerations are passed through.
PSN hosted a conference call on December 1st at 4pm EST with national experts and legislative leaders to discuss Prescription Drug Reforms and the 2010 Multi-State Agenda. Speakers discussed policy details, how federal reform could impact these initiatives, and best practices for building campaigns and moving Rx reform initiatives.
As part of our Shared Multi-State Agenda,
the Progressive States Network is working with legislators, advocates
and leading experts to promote Rx reforms in 2010 that will reduce
health care costs for consumers, businesses, and state and local
governments, and will help ensure access to safe and effective
medications. Through coordinated, strategic support, PSN and our
allies will be working to introduce and advance Rx reforms that will
help address state budget deficits and improve access to quality
medications in as many states possible; providing model legislation,
policy analysis, messaging and more - all of which has been gathered
and will be constantly updated on our Prescription Drug Reform Shared Agenda web page.