In Review: Both chambers took a break from Spring Session this week. The House returns this Tuesday through Friday with the House committee deadline on Friday, April 5. The Senate remains in-district this week and returns on Tuesday, April 9.
Up Next: The Department of Insurance is requesting that HB 4548, a DOI initiative on PBM restrictions, including mandated dispensing fees, restricted pharmacy networks, banned spread-pricing, required disclosures of proprietary information, etc. be called in the House Healthcare Availability Committee on Tuesday at 4:00 P.M. There is a new amendment to HB 4548, but the only change is the specific exemption of Medicaid and ERISA/union plans. We are reaching out to Chairman Natalie Manley (D) and sponsor Representative Thaddeus Jones (D) to ask them to continue holding the bill due to opposition and significantly high costs, but neither has responded due to the holiday. At this point, we need to assume that HB 4548 will be called in committee for a vote tomorrow. House Bill 5051 will also be heard in the House Health Care Availability Committee. The bill prohibits prior authorization on drugs prescribed for 6 months or for insulin, HIV preventative, HIV treatment, hepatitis, estrogen, or progesterone. Lori Reimers, PCMA counsel, has talked with Representative Jenn Douglass (D) and explained that the Insurance industry is working with Senator Cristina Castro (D) on SB 3732 on prior authorizations similar to this bill. There is still an opportunity to offer language. House Bill 4055, a bill that prohibits prior authorization for emergency services performed outside an emergency department, will be heard in the House Insurance Committee on Tuesday at 2:00 P.M. The proponents accepted this language as an amendment to replace the bill: Notwithstanding any other provision of law, a health insurance issuer or a contracted utilization review organization may not require prior authorization for drug therapies approved by the US Food & Drug Administration for the treatment of hereditary bleeding disorders any more frequently than six months or as long as the prescription dosage remains valid, whichever period is shorter.
If you have any questions, please contact Melodie Shrader at mshrader@pcmanet.org.
