In Review: The Committee on Health Coverage, Insurance, and Financial Services (HCIFS) held a work session on LD 796 and LD 1407. For LD 796 (Representative Jane Pringle (D)), PCMA presented to the committee our concerns with some of the prior authorization reporting requirements and requested a section be struck that would allow a provider to administer a drug before obtaining prior authorization. The committee voted to table LD 796, and the sponsor will continue to work with stakeholders. LD 1407, which would allow pharmacies to reject a PBM’s provider manual updates, was amended by the bill sponsor just before the hearing. The amendment would no longer allow pharmacies to object to provider manual updates, and any reimbursement policy changes above $500,000 need to come with a good-faith estimate. Also, provider manual update changes can be made four times a year unless a change is due to a State or Federal law change. The committee voted ought to pass on the amendment bill.

Up Next: HCIFS will hold a work session on Thursday, January 25, at 1:30 P.M., on two carry-over bills from the previous session. The first is LD 1165 (Representative Margaret Craven (D)), which deals with rebates being offered to the patient at the point-of-sale. The next bill is LD 1829 (Senator Cameron Reny (D)), which deals with reference pricing. PCMA will participate in the work session for both bills.

If you have any questions, please contact Sam Hallemeier at shallemeier@pcmanet.org.