On July 31, 2019, Governor Charles Baker signed a law designed to increase supplemental rebates for prescription drugs in the Massachusetts Medicaid program (MassHealth). This law follows on a somewhat similar law enacted in New York in 2017.
Under the new Massachusetts law, the state’s Executive Office of Health and Human Services (EOHHS) can propose and negotiate for supplemental rebates for covered outpatient drugs directly with pharmaceutical manufacturers under an exemption to the Massachusetts public…
During the summer of 2019, a number of states enacted new drug price transparency laws, swelling the number of states with such laws to 11. Colorado, Maine, Maryland, Texas, and Washington joined California, Connecticut, Louisiana, Nevada, and Oregon with transparency laws. Oregon also supplemented its transparency laws with an advance notice requirement for certain price increases.
Washington: On May 9, Washington enacted HB 1224. Under this law, drug manufacturers would have to provide at…
On July 31, 2019, Governor Charles Baker signed a law designed to increase supplemental rebates for prescription drugs in the Massachusetts Medicaid program (MassHealth). This law follows on a somewhat similar law enacted in New York in 2017.
Under the new Massachusetts law, the state’s Executive Office of Health and Human Services (EOHHS) can propose and negotiate for supplemental rebates for covered outpatient drugs directly with pharmaceutical manufacturers under an exemption to the Massachusetts public…
On April 11, 2019, the Massachusetts House Committee on Ways and Means released its FY 2020 budget (H.3800). The legislation includes provisions authorizing MassHealth (the Massachusetts Medicaid program) to negotiate supplemental rebates directly with drug manufacturers, and provides for further proceedings before the Health Policy Commission for manufacturers refusing to negotiate supplemental rebates at levels satisfactory to the Commonwealth. These provisions represent amendments to a MassHealth drug pricing proposal included in Governor Baker’s…
On April 11, 2019, the Massachusetts House Committee on Ways and Means released its FY 2020 budget (H.3800). The legislation includes provisions authorizing MassHealth (the Massachusetts Medicaid program) to negotiate supplemental rebates directly with drug manufacturers, and provides for further proceedings before the Health Policy Commission for manufacturers refusing to negotiate supplemental rebates at levels satisfactory to the Commonwealth. These provisions represent amendments to a MassHealth drug pricing proposal included in Governor Baker’s…
Happy New Year! While healthcare developments have been relatively slow lately due the ongoing partial Federal shutdown, an important story did arise over the most recent Holidays. We previously wrote about a lawsuit filed in November 2017 by a group of hospital trade associations against the Department of Health and Human Services (HHS) opposing a major change in Medicare reimbursement policy when 340B hospitals purchase drugs under the 340B program for use in the hospital…
On December 13, 2018, the Medicaid and CHIP Payment and Access Commission (MACPAC) held its December 2018 public meeting.
Dr. Paul Jeffrey, the Director of Pharmacy for MassHealth, spoke on MassHealth’s drug pricing approach, in particular with respect to a drug pipeline he described as “alarming” in terms of cost but “sensational” in terms of potential impact. Although Dr. Jeffrey suggested that implementing a closed formulary would require waiver authority (which CMS denied Massachusetts last…
The recently enacted California drug price transparency law SB 17 is facing a legal challenge to its constitutionality in the form of a PhRMA lawsuit filed in the US District Court for the Eastern District of California on December 8. In PhRMA v. Brown, PhRMA is seeking declaratory judgment that the drug pricing provisions of SB 17 are unconstitutional and a permanent injunction against their implementation and enforcement.
PhRMA is challenging the constitutionality of…
California’s Office of Statewide Health Planning and Development (OSHPD) has released an implementation plan for California’s new drug transparency law SB 17. The first part of the law to take effect will require manufacturers of drugs experiencing greater than 16% increases in WAC over three calendar years to provide 60 days’ advance notice to state purchasers as well as healthcare service plans, health insurers, and PBMs that register with OSHPD. OSHPD is planning to compile…
On October 9, California Governor Jerry Brown signed SB 17, legislation mandating advance notice and price transparency reporting for drugs experiencing greater than 16% increases in WAC over three calendar years and new drugs introduced at a WAC above the Medicare Part D specialty drug threshold. The legislation will take effect January 1, 2018, although the reporting requirements to the Office of Statewide Health Planning and Development will begin in the first quarter of…