An Act To Reduce the Cost of Prescription Drugs Purchased by the State and Counties by Using Section 340B of the Federal Public Health Service Act
Maine Legislature, Session 123, LD 2231
Committee Amendment CA_A_H1011 (House)

COMMITTEE AMENDMENT "It" to H.P. 1591, L.D. 2231, Bill, "An Act To 
Reduce the Cost of Prescription Drugs Purchased by the State and Counties by Using 
Section 340B of the Federal Public Health Service Act" 
Amend the bill by inserting after the title and before the enacting clause the 
following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, it is essential to reduce the cost of prescription drugs purchased by the 
State and counties as soon as possible; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, ' 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. Prescription drugs. The Governor's Office of Health Policy and Finance 
shall coordinate with the Department of Health and Human Services and other state 
agencies and representatives of state employees, health care providers and federal1y 
qualified health centers to identify opportunities no later than July 1, 2009 to provide 
prescription drugs through Section 340B of the federal Public Health Service Act, 42 
United States Code, Section 256b (2006) for the following, if the costs of implementing 
such a plan are less than the current cost of providing prescription drugs: 
1. State-funded managed care plans; 
2. MaineCare; 
3. State bulk purchasing initiatives; and 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .. A" to H.P. 1591, L.D. 2231 
4. Populations using high-cost chronic care and specialty drugs. In carrying out the 
provisions of this subsection, the Department of Health and Human Services shall by 
January 15, 2009 prepare and issue a request for proposal for speciality drugs with the 
greatest potential for savings. The Department of Health and Human Services shall 
report to the joint standing committees of the Legislature having jurisdiction over 
appropriations and financial affairs and health and human services matters by January 15, 
2009 on the opportunities identified and the request for proposal. 
Sec. 2. Prescription drugs; corrections and county jails. The Department of 
Corrections shall convene a working group with members including the director of health 
care services, the director of clinical and treatment services and the mental health 
criminal justice manager within the department; 3 persons representing the counties 
including at least one sheriff or designee of a county participating in the statewide 
Department of Corrections pharmacy contract; the director of pharmacy affairs in the 
Governor's Office of Health Policy and Finance; and representatives of employees, 
covered entities and other interested persons. 
The working group shall identify 
opportunities to provide prescription drugs through Section 340B of the federal Public 
Health Service Act, 42 United States Code, Section 256b (2006) to inmates and 
employees in youth correctional facilities, county jails and state prisons, where cost 
effective and practicable. 
The Department of Corrections shall report to the joint 
standing committees of the Legislature having jurisdiction over appropriations and 
financial affairs and health and human services matters as necessary to incorporate any 
recommendations into future contracts, but at minimum an interim report must be 
provided to both joint standing committees by January 15, 2009 and a final report must be 
provided to both committees by January 15,2010. 
The Department of Corrections shall promptly enter into negotiations with its current 
medical services and pharmacy contractor to recover a greater percentage of rebates, 
discounts and other financial considerations paid by prescription drug manufacturers and 
wholesalers to that contractor, and shall incorporate provisions into future contracts that 
comply with the provisions of the Maine Revised Statutes, Title 22, chapter 603, 
subchapter 4, including transparency, conflict of interest and rebate pass-through 
I 
req uirements. 
Sec. 3. Covered entities. In developing and implementing the plans required in 
sections 1 and 2 of this Act, the Department of Health and Human Services and the 
Department of Corrections shall consider all health care providers and facilities in the 
State potentially eligible for designation as covered entities under Section 340B of the 
federal Public Health Service Act, 42 United States Code, Section 256b (2006), including 
without limitation all hospitals eligible as disproportionate share hospitals; recipients of 
grants from the United States Public Heath Service; federally qualified health centers; 
federally qualified look-alikes; state-operated AIDS drug assistance programs; Ryan 
White CARE Act Title I, Title II and Title III programs; tuberculosis, black lung, family 
planning and sexually transmitted disease clinics; hemophilia treatment centers; public 
housing primary care clinics; and clinics for homeless people. 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
COMMITTEE AMENDMENT 
COMMITIEE AMENDMENT· A" to H.P. 1591, L.D. 2231 
SUMMARY 
This amendment replaces the bill and removes language that requires that counties 
and the Department of Corrections contract only with entities that are eligible to 
participate in the purchase of prescription drugs under Section 340B of the federal Public 
Health Service Act. 
This amendment requires the Governor's Office of Health Policy and Finance to 
coordinate with the Department of Health and Human Services in identifying 
opportunities to provide prescription drugs through Section 340B. 
It directs the 
Department of Health and Human Services to prepare and issue a request for proposal for 
specialty drugs with the greatest potential for savings. 
It directs the Department of 
Corrections to convene a working group to identify opportunities for cost savings through 
Section 340B. It directs the Department of Corrections to enter into negotiations with its 
current medical services and pharmacy contractor to recover a greater percentage of 
rebates and discounts paid by prescription drug manufacturers and wholesalers. 
FISCAL ~OTE REQURED 
(See attached) 
COMMITTEE AMENDMENT 
• 
Approved: 04/14/08 ::tvac::.. 
LD 2231 
LR 3501(02) 
An Act To Reduce the Cost of Prescription Drugs Purchased by the State and Counties by Using 
Section 340B of the Federal Public Health Service Act 
Fiscal Note for Bill as Amended by Committee Amendment" (1" 
Committee: Appropriations and Financial Affairs 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Fiscal Detail and Notes 
Any additional costs to the Department of Health and Human Services, the Department of Corrections, or the 
Governor's Office of Health Policy and Finance can be absorbed utilizing existing budgeted resources. 
LR3501(02) - Fiscal Note - Page 1 of 1