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May Legislative Update

Updates on Budget and Current Legislation

Kelly Vyzral, Director of Government Affairs

Budget Update
It's that time again: Bi-annual budget time! This is a call to action - we need your help! OPA worked to get several changes in the budget language. We need your help to keep those changes in place in the Senate. But there are several areas that are still of concern to us. We need your help to get those changes made. Below is a summary of the budget as it was passed out of the House into the Senate. After each section is a point of action for you. Call your state senator and explain to him/her the importance of the changes we have made, and stress your concern over the issues that are still unresolved. Please call them THIS WEEK to make an impact.

House Bill 66: the Biennial Budget was narrowly passed by the Ohio House of Representatives on April 12. The vote was 54-45 and fell mostly on party lines. It is now in the Senate Finance Committee. We were able to make some changes in the Medicaid portion of the budget, but several provisions remain a major concern to the Ohio Pharmacists Association.

Currently, HB 66 proposes to:
  1. Reduce Medicaid reimbursement for product cost from WAC + 9% to WAC + 7%. When you talk to your legislators, remind them that reducing your product reimbursement doesn't change how much it costs you to purchase the product from the manufacturer; it only reduces the amount you are reimbursed by Medicaid.
  2. Institute Co-pays on some Medicaid prescriptions.

    • $3 on all non-formulary drugs
    • $2 on brand name drugs

    We were successful in having the co-pay taken off generic drugs. We feel this is one way to encourage patients to use the least expensive generic drugs.

  3. Right of Refusal Language. We were able to have language added that will allow pharmacists the right to refuse service to patients who refuse to pay the co-pay after the first time, if this is the normal course of business with cash paying customers and third party payers. This is being done in several other states and would allow pharmacists to make a personal decision on a case-by-case basis in the course of their daily business. This will not only save pharmacists millions of dollars in unpaid debt, but it will make patients more aware and involved in their own healthcare decisions.

  4. Daily price updates on generic drugs in the Medicaid program. OPA worked to get language in the Budget to update your prices in the Medicaid program on a daily basis, to help recognize the increasing costs of drugs. We are especially concerned because Medicaid is cutting separate "supplemental rebate" deals with drug manufacturers. This is causing Medicaid to force pharmacies to dispense brand name drugs, when the pharmacy buys generics cheaper. A modification was made in the language to update only GENERIC prices, leaving brand names to be only updated MONTHLY! When you talk to your state senator, explain why it is critical for your brand names to be updated daily or AT LEAST weekly.

  5. Eliminate the requirement of ODJFS to conduct a Medicaid Dispensing Fee survey every two years with the purpose of helping ODJFS establish the Medicaid dispensing fee. This does not bode well for fair and reasonable dispensing fee increases in the future. OPA is fighting to have the language authorizing the survey restored to the budget, and we feel the results of the survey should be taken more seriously when the Department sets the Medicaid dispensing fee.

  6. The Board of Pharmacy will not be consolidated into the Board of Health. It will remain a stand alone entity.

One disturbing issue that appeared suddenly in the budget as it passed out of the House Finance Committee was the addition of language to regulate the sale of pseudoephedrine. The language in the budget is very restrictive and punitive towards pharmacy. It allows for the purchase of two packages or 3 grams of product within a 30-day period. If the product is sold in a retail store, it must be in a secure, locked area. If it is sold at a pharmacy, it must be kept behind the counter. It places stiff penalties on the purchaser and on those attempting to use the psuedoephedrine to manufacture methamphetamine, which OPA agrees with, but it also attempts to punish the pharmacy as well by making even an accidental violation of the law a misdemeanor punishable with a fine of up to $350 for a first offense.

We have been working with Senator Carey for about six months on legislation to regulate pseudoephedrine as it is used in the manufacturing of illegal methamphetamine. (See SB 53 below.) Our work has been very cooperative and we had hopes that a compromise bill was possible. We will be talking to all members of the Senate in an effort to have this language stripped out of the budget. It is an important issue and deserves to be heard on its own merit.

Update on Current Legislation
SB 18: Compounding. Sen. Wachtmann (R-Napoleon). This bill will allow pharmacists to do non-patient specific compounding for office use. The legislation passed unanimously out of the House Health Committee and now waits signature by the Governor. The Ohio Pharmacists Association supported this bill, and worked with the sponsor as well as the Board of Pharmacy to see it through to a successful conclusion.

SB 53: Methamphetamine Precursors. Sen. John Carey (R-Wellston), chairman of the Senate Finance & Financial Institutions Committee, introduced this legislation. The bill would require that all products containing pseudoephedrine as the only active ingredient be placed behind the counter. Purchases would be limited to two (2) packages or 6 grams, and customers would have to show a photo ID to prove they are over 18-years-old. There would be no registry requirement. There are currently no penalties in the bill, but may be added on the purchaser. OPA has expressed concern about the increased time that a pharmacist would have to take to police this drug. OPA will continue to work with the sponsor and other interested parties to find a solution that does not inconvenience our patients or OPA members. If you have a suggestion that could be reasonable, let us know. We continue to explore options to reduce pseudoephedrine misuse, while allowing reasonable access.

SB 14: Drug Importation Program. Sen. Hagan (D-Youngstown). This bill would create the Drug Importation Program under which public employee benefit plans are permitted to purchase drugs from approved drug distributors located outside the United States, and requires the State Board of Pharmacy to adopt rules governing the Program, including rules for the approval of non-domestic distributors. OPA is adamantly opposed to this legislation.

HB 89: Price Posting. Rep. Blessing (R-Cincinnati). This legislation would require the Board of Pharmacy to compile a list of the top 100 prescription drugs according to price, and update it every three months. Each pharmacy would then be required to post this list along with pricing information, and update the prices at least every two weeks. OPA is opposing this bill, since it will increase work and costs for pharmacies, and not produce a significant benefit for patients. Violations of this proposed legislation would result in misdemeanor charges. OPA has been able to stop the bill from being passed for at least the past several years. This year, however, the bill has taken new life, and many members of the House of Representatives Health Committee think price posting of prescription drugs is a good idea. In last month's journal, we provided Health Committee members with information in the form of testimony from one of our pharmacist members and from a pharmacy student as to why price posting is both unnecessary and promotes the dangerous practice of pharmacy shopping. Ohio law already requires pharmacies to give pricing over the phone if it is requested. OPA will continue to actively oppose this piece of legislation. Please contact your state representative expressing your opposition to this legislation.

To determine your state senator click on the following link:
http://www.senate.state.oh.us/senators/
To determine you state representative, click on the following link: http://www.house.state.oh.us/jsps/Representatives.jsp.

If you have any questions or comments about the bills or issues mentioned in this article, please contact Kelly Vyzral, Director of Government Affairs at 614.586.1497 or kvyzral@ohiopharmacists.org.

What is the Ohio Pharmacy PAC?
The Pharmacy Political Action Committee is a voluntary, nonprofit, nonpartisan organization of pharmacists who are interested in promoting good government and public health. Pharmacy PAC money contributed by pharmacists goes to help candidates who support pharmacy in Ohio. That's right, your money is used to support political clout for Pharmacy right here in Ohio!

To make a secure online donation to the Ohio Pharmacy PAC, $$Link,AWS_SSL:DisplayInputForm&FormID=37, CLICK HERE!$$

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