An Act To Ensure Fairness in Maine's Prescription Drug Laws
Maine Legislature, Session 121, LD 0849
Committee: Health and Human Services
Sponsors: CANAVAN, DOUGLASS, CRAVEN, FLETCHER, GERZOFSKY, LA VERRIERE-BOUCHER, PINGREE, SMITH, SNOWE-MELLO, WALCOTT

Legislative Document 
No. 849 
H.P.626 
House of Representatives, February 20, 2003 
An Act To Ensure Fairness in Maine's Prescription Drug Laws 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative CANAVAN of Waterville. 
Cosponsored by Senator DOUGLASS of Androscoggin and 
Il/~ 
/J1·1714C~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: CRAVEN of Lewiston, FLETCHER of Winslow, GERZOFSKY of 
Brunswick, LA VERRIERE-BOUCHER of Biddeford, PINGREE of North Haven, SMITH of 
Van Buren, SNOWE-MELLO of Poland, WALCOTT of Lewiston. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRS A §3174-M. as renumbered by 
RR 
1993, c. 
L 
§53, is amended to read: 
§3174-M. Medicaid drug management programs 
1. 
Authority _ 
The 
department 
has 
the 
authority 
to 
determine 
which 
prescription 
and 
over-the-counter 
drugs 
are 
subject to reimbursement and coverage under the Medicaid program 
and to establish procedures for the use and management of 
thos~ 
drugs. 
2. 
Drug conanittee. 
In order to make determinations under 
subsection 1, the department shall establish a drug fer;:mH±ar;:y 
commi ttee by rule adopted pursuant to the Maine Administrative 
Procedure Act. 
The department must receive approval from the 
committee 
prior 
to 
establishing 
any 
limitations, 
prior 
authorizations, preferred drug programs or other mechanis1ns to 
monitor or restrict the manner in which physicians prescribe 
drugs or Medicaid program recipients have access to drugs. 
A. 
The 
drug 
fer;:mH±ar;:y 
committee 
must 
have 
at least 
aeavetiaEj consumer members and 2 psychiatrist members, one 
of whom must be a child psychiatrist and one of whom must be 
an adult psychiatrist, 
to be 
appointed 
by 
the Medicaid 
Advisory 
Committee 
established 
pursuant 
to 
Code 
of 
Federal Regulations, Section 431.12 (1993). 
B. 
A vote of 2/3 of the 
present is required to add 
drugs that are subject to 
the Medicaid program. 
drug fer;:mH±ar;:y committee members 
or delete a drug from the list of 
reimbursement and coverage under 
C. 
A 
determination 
under 
rules 
adopted 
pursuant 
to 
subsection 3 that a drug or category of drug is not covered 
by the Medicaid program is a final agency action subject to 
review under the Maine Administrative Procedure Act. 
3. 
Procedures; emergency. 
Drugs determined not covered by 
Medicaid pursuant to this section are subject to 
review and 
approval based upon a prior approval procedure established by 
rule 
by 
the 
department. 
Prior 
approval 
must 
be 
given 
retroactively if an emergency, 
as 
determined by 
a 
physician, 
requires that the drug be dispensed immediately for the patient's 
well-being. 
Any drug provided under this emergency procedure is 
considered a Medicaid-covered service pending departmental action. 
4. 
Rulemaking_ 
Rules adopted pursuant to section 3l74-J 
prior to its repeal are effective as of the effective date of 
Page l-LR0779(1) 
this chapter without the taking of any action pursuant to the 
Maine Administrative Procedure Act. 
SUMMARY 
This bill requires 
the 
Department of 
Human 
Services 
to 
receive approval from the drug committee, established pursuant to 
the Maine Revised Statutes, Title 22, section 3174-M, subsection 
2, prior to establishing any mechanisms to monitor or restrict 
the 
manner 
in 
which 
physicians 
prescribe 
drugs 
or 
Medicaid 
program recipients have access to drugs. 
The bill also requires 
that 2 members of the committee must be psychiatrists, one a 
child psychiatrist and one an adult psychiatrist.