SPONSOR:

Rep. B. Short

HOUSE OF REPRESENTATIVES

148th GENERAL ASSEMBLY

HOUSE AMENDMENT NO. 1

TO

HOUSE BILL NO. 284

AMEND House Bill No. 284 by striking all text on lines 49 through 51 and inserting in lieu thereof the following:

(1) It is listed as “A” rated in the most recent version of the FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations, also known as the Orange Book, or is listed as “B” rated in the most recent version of the FDA’s Approved Drug Products without Therapeutic Equivalence Evaluations, also known as the Orange Book, or has an “NR” or “NA” rating or a similar rating by a nationally recognized reference.

FURTHER AMEND House Bill No. 284 by striking the phrase “and receive a response regarding the appeal status within 2 business days” as it appears on lines 71 and 72.

FURTHER AMEND House Bill No. 284 by striking all text on lines 75 through 78 and inserting in lieu thereof the following:

(d) If the appeal is sustained, the pharmacy benefits manager shall make the price correction, permit the reporting pharmacy to reverse and rebill the appealed claim, and make the price correction effective for all similarly situated pharmacies from the date of the approved appeal.

SYNOPSIS

This amendment makes clarifications regarding which drugs may be placed on a MAC list, how appeals are handled, and the process that will occur when an appeal is sustained.