Public Health Committee

JOINT FAVORABLE REPORT

SPONSORS OF BILL:

Public Health Committee

REASONS FOR BILL:

To allow nursing home facilities to make substitutions for drugs prescribed to patients with the approval of the prescribing physician.

RESPONSE FROM ADMINISTRATION/AGENCY:

None Submitted

NATURE AND SOURCES OF SUPPORT:

Mike Gemma, RPh, MBA, Pharmacy Manager, Omnicare of Connecticut:

The purpose of this bill is to help nursing homes manage their prescription drug cost for patients transitioning from a hospital to a nursing home facility. Medicare assigns different coverage and patients who transitioned from a hospital to a skilled nursing home are generally covered under Medicare A for a maximum of 100 days until the patient is approved for either Medicare D or Medicaid.

Medicare-A reimbursement to nursing homes are capped during the transition period and we are responsible for the additional cost of all prescriptions.

HB-5516 provides facilities with an additional cost effective tool of prescription drug formularies. These formularies are a standard of drug utilization management used by each payer of prescription drugs, including hospitals, Medicaid, Medicare-D and commercial benefit plans. They allow for the prescribing practitioner to permit cost effective substitutions in accordance with the facility's clinical protocol, similar to a standard practice used by hospitals.

This bill will give nursing homes a well established and effective approach to manage prescription drug cost where the demand and pressures to manage health care cost have never been greater.

Matthew V. Barrett, Executive Vice President, Connecticut Association of Health Care Facilities (CAHCF):

This is important legislation that will assist nursing homes manage their prescription costs in situations where their residents have transitioned from a hospital. Measures to lower costs are particularly important in the current fiscal environment at both the state and federal levels of government, where regrettably Medicare reductions as high as 16% have been experienced by nursing homes in Connecticut while Medicaid continues to pay below facility costs.

The provisions in this bill allows prescribing practitioners the ability to authorize cost effective prescription drug substitutions without comprising quality of care.

NATURE AND SOURCES OF OPPOSITION:

None Submitted