Connecticut Seal

General Assembly

Amendment

 

January Session, 2013

LCO No. 8839

   
 

*HB0670508839SRO*

Offered by:

 

SEN. MCKINNEY, 28th Dist.

SEN. FASANO, 34th Dist.

SEN. BOUCHER, 26th Dist.

SEN. CHAPIN, 30th Dist.

SEN. FRANTZ, 36th Dist.

SEN. GUGLIELMO, 35th Dist.

SEN. KANE, 32nd Dist.

SEN. KELLY, 21st Dist.

SEN. KISSEL, 7th Dist.

SEN. LINARES, 33rd Dist.

SEN. MARKLEY, 16th Dist.

SEN. MCLACHLAN, 24th Dist.

SEN. WELCH, 31st Dist.

SEN. WITKOS, 8th Dist.

To: House Bill No. 6705

File No.

Cal. No.

(As Amended by House Amendment Schedules "A" and "C")

"AN ACT IMPLEMENTING THE GOVERNOR'S BUDGET RECOMMENDATIONS FOR HOUSING, HUMAN SERVICES AND PUBLIC HEALTH. "

Strike section 81 in its entirety and renumber the remaining sections and internal references accordingly

Strike section 99 in its entirety and insert the following in lieu thereof:

"Sec. 99. Section 17b-280 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2014):

(a) The state shall reimburse for all legend drugs provided under medical assistance programs administered by the Department of Social Services at the lower of (1) the rate established by the Centers for Medicare and Medicaid Services as the federal acquisition cost, (2) the average wholesale price minus sixteen per cent, or (3) an equivalent percentage as established under the Medicaid state plan. Notwithstanding the provisions of this section, contingent upon federal approval, on and after October 1, 2012, for independent pharmacies, the state shall reimburse for such legend drugs at the lower of (A) the rate established by the Centers for Medicare and Medicaid Services as the federal acquisition cost, (B) the average wholesale price minus fifteen per cent, or (C) an equivalent percentage as established under the Medicaid state plan. The state shall pay a professional fee of one dollar and seventy cents to licensed pharmacies for each prescription dispensed to a recipient of benefits under a medical assistance program administered by the Department of Social Services in accordance with federal regulations. On and after September 4, 1991, payment for legend and nonlegend drugs provided to Medicaid recipients shall be based upon the actual package size dispensed. Effective October 1, 1991, reimbursement for over-the-counter drugs for such recipients shall be limited to those over-the-counter drugs and products published in the Connecticut Formulary, or the cross reference list, issued by the commissioner. The cost of all over-the-counter drugs and products provided to residents of nursing facilities, chronic disease hospitals, and intermediate care facilities for the mentally retarded shall be included in the facilities' per diem rate. Notwithstanding the provisions of this subsection, no dispensing fee shall be issued for a prescription drug dispensed to a [ConnPACE or] Medicaid recipient who is a Medicare Part D beneficiary when the prescription drug is a Medicare Part D drug, as defined in Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

(b) The Department of Social Services may provide an enhanced dispensing fee to a pharmacy enrolled in the federal Office of Pharmacy Affairs Section 340B drug discount program established pursuant to 42 USC 256b or a pharmacy under contract to provide services under said program.

(c) For purposes of this section, (1) "independent pharmacy" means a privately-owned community pharmacy that has five or fewer stores located in the state; (2) "community pharmacy" has the same meaning as in section 20-631a; and (3) "legend drug" has the same meaning as in section 20-571.

(d) The commissioner shall submit a Medicaid state plan amendment not later than October 1, 2012, to establish the independent pharmacy rate pursuant to subsection (a) of this section. "