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OUR KPhA Weekly Legislative Update

and Grassroots Alert to Action

February 26, 2016

GRASSROOTS ALERT
CALL TO ACTION: Contact your Senator and let him/her know how important SB 117 is to you as a pharmacist and to independent pharmacies across Kentucky. Remembe r to thank your Senator for that support. YOU can call your Senator and leave a message on the LEGISLATIVE HOTLINE (800) 372-7181 or contact him/her at home if you have a personal relationship.
Our goal is for the legislation to pass out of the Senate next week. OUR KPhA will notify members as soon as the bill passes via social media and email.
 
PBM Transparency Bill Assigned to Senate Appropriations and Revenue Committee
OUR KPhA continues to work on Senate Bill 117 sponsored by Senator Max Wise. While this legislative is of special importance to independent pharmacists, it is vital for the entire profession in that what threatens one segment of the profession hurts us all.  This legislation would improve Kentucky's existing MAC transparency legislation to ensure that it is fully implemented as it was intended when originally passed in 2013. The legislation would require Pharmacy Benefit Managers (PBMs) to be licensed by the Department of Insurance and it would require PBMs to enhance their existing appeals processes and increase MAC transparency. This is KPhA's top legislative priority.  
Although Kentucky Medicaid has been subject to MAC transparency legislation since 2013, current claims focus on the cost to enact SB 117.  As a result, some senators have become concerned about the fiscal impact of the legislation.  Arguably, the only reason that there would be a cost increase is if Medicaid admits that it is underpaying pharmacists in Kentucky based on contracts signed with the PBMs. The Senate Chair of the Appropriations and Revenue Committee, Chris McDaniel (R-Taylor Mill), is currently waiting to get all of the fiscal analysis back from state agencies in order to fully analyze the budgetary impact of SB 117.
The Pharmacy Benefit Managers (PBMs) continue to oppose language in the legislation that would allow the Kentucky Department of Insurance (DOI) to request their methodology in order to make determinations in appeals disputes.  KPhA and our pharmacy partners have agreed that this information will be kept confidential by DOI. PBMs contend that they will immediately sue the state if the language is included in SB 117.  Other work continues by KPhA and our pharmacy partners to analyze and respond to the fiscal impact statements.
KPhA expects SB 117 to be heard on Tuesday in the Senate Appropriations and Revenue committee.
 
Bill would Prohibit Mandatory Mail Order and Define Specialty Drugs
House Banking and Insurance Committee Chair Jeff Greer (D- Brandenburg) filed HB 458 which would prohibit insurers from requiring patients to switch to mail order pharmacy from retail pharmacy. It also would prohibit insurers from requiring different cost-sharing arrangements for mail order.
House Bill 458 would define the term "specialty drug," which would make Kentucky the first state in the country to do so. Recently, insurance companies have started placing drugs on specialty lists that retail pharmacies have been safely dispensing. This is a growing problem for retail pharmacies, and there is no uniform definition among insurers for specialty drugs. House Bill 458 would limit the definition of a specialty drug to those drugs that would require special handling and patient education by the drug manufacturer or those that are on a FDA drug shortage list. The bill has been assigned to the House Banking and Insurance Committee and is expected to be heard in committee next week.
 
Board of Pharmacy Pursues Priority Legislation
Legislation Advances Requiring Criminal Background Checks for Pharmacy Technicians
The House Health and Welfare Committee unanimously passed legislation that would require new pharmacy technicians as of April 1, 2017 to undergo a fingerprint-based criminal background check through the FBI and the Kentucky State Police. Representative Mary Lou Marzian (D-Louisville) is the sponsor of
HB 398  and it now moves to the House floor for further action.
Bill would Repeal Reciprocity Agreements for DME Providers
Former Attorney General Jack Conway provided the Kentucky Board of Pharmacy with an informal opinion that legislation passed in a previous session, requiring reciprocity for durable medical equipment providers only with the seven contiguous surrounding states, is unconstitutional. As a result, the Kentucky Board of Pharmacy is seeking the passage of  HB 397  that would repeal the existing law and have the same standards for licensure of durable medical equipment providers based in all 50 states. Representative Mary Lou Marzian (D-Louisville) is sponsoring the legislation.
Legislation would Create New License Categories for Certain Entities
The Kentucky Board of Pharmacy is pursuing legislation that would require permitting of in-state and out-of-state outsourcing facilities that perform non-patient-specific compounding.
House Bill 437, sponsored by Representative Russ Meyer (D-Nicholasville), is a necessary statutory update as a result of the federal law revisions. It also would update the license requirements for third party logistics providers like UPS. Finally, non-pharmacists in the medical wholesale gas business would be required to be licensed separately as a result of HB 437 .This bill has been assigned to the House Health and Welfare Committee.
 
Biosimilars Legislation Stalled in Senate
Legislation requiring pharmacists to substitute FDA-approved interchangeable biosimilars for the brand-name biologic product is stalled in the Senate.
Senate Bill 134 also requires pharmacists to contact the prescriber and notify them when they dispense any biologic product where there is an interchangeable biosimilar on the market. KPhA is opposed to any notification requirement that adds a burden to the workflow of the pharmacist. It is unclear when the legislation will move out of the Senate.
This week, the Kentucky Center for Investigative Reporting took a look at SB 134 and the increased number of lobbyists working on behalf of the pharmaceutical industry. Public Citizen, a Washington, D.C.-based group, argues that SB 134
should be modeled after the existing generic substitution law. 

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Kentucky Pharmacists Association
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