An Act To Improve Oversight of Pharmaceutical Purchasing
Maine Legislature, Session 124, LD 1339
Committee: Health and Human Services
Sponsors: TREAT, ALFOND, BUTTERFIELD, CAIN, CONNOR, HILL, MARTIN, PERRY, WEBSTER, CRAVEN
Amends: 22 MRSA §2699

FIRS'!' REGULAR SESSION-2009 
Legislative Document 
No. 1339 
H.P.940 
House of Representatives, March 31, 2009 
An Act To Improve Oversight of Pharmaceutical Purchasing 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative TREAT of Hallowell. 
Cosponsored by Senator ALFOND of Cumberland and 
17/~/J1·771~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: BUTTERFIELD of Bangor, CAIN of Orono, CONNOR of Kennebunk, HILL 
of York, MARTIN of Eagle Lake, PERRY of Calais, WEBSTER of Freeport, Senator: 
CRAVEN of Androscoggin. 
Printed on rec:yc:led paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA §2699, sub-§l, ~C-l is enacted to read: 
C-l. 
"Individually identifying information" means information derived from or 
relating to a prescription for a prescribed product that directly or indirectly identifies 
a patient or a prescriber. 
Sec. 2. 22 MRSA §2699, sub-§l, ~-1 is enacted to read: 
D-l. "Marketing" means any activity of a pharmacy benefits manager, alone or in 
collaboration with a company making or selling prescribed products, that is intended 
to influence prescribing or purchasing choices, including but not limited to: 
(1) 
Advertising, publicizing, promoting or sharing information about a 
prescribed product; 
(2) Identifying individuals to receive a message promoting use of a prescribed 
product, including but not limited to an advertisement, brochure or contact by a 
sales representative; 
(3) Planning the substance of a sales representative visit or communication or the 
substance of an advertisement or other promotional message or document; 
(4) Evaluating or compensating sales representatives; 
(5) 
Identifying individuals to receive any form of gift, prescribed product 
sample, consultancy or other item, service, compensation or employment of 
value; and 
(6) Advertising or promoting prescribed products directly to patients, including 
through refill reminders or information about alternative prescribed products. 
Sec. 3. 22 MRSA §2699, sub-§l, ~G is enacted to read: 
G. "Prescriber" has the same meaning as in section 1711-E, subsection 1, paragraph 
G-l. 
Sec. 4. 22 MRSA §2699, sub-§6 is enacted to read: 
6. Registration with Bureau of Insurance. A pharmacy benefits manager may not 
enter into a contract with a covered entity for pharmacy benefits management in this State 
unless the pharmacy benefits manager registers with the Department of Professional and 
Financial Regulation, Bureau of Insurance on a form and in a manner prescribed by the 
Bureau of Insurance. The Bureau of Insurance shall establish a registration fee. Fees 
collected under this subsection must fund the costs of registration and enforcement of this 
section by the Attorney General. 
Sec. 5. 22 MRSA §2699, sub-§8 is enacted to read: 
8. 
Compliance; audits. The State Auditor shall work with the Department of 
Administrative and Financial Services, Bureau of General Services and other state 
agencies, including, but not limited to, state employees, teachers and the Maine Turnpike 
) 
') 
) 
~\ 
~ 
.I 
/' 
\., 
.. 
Authority, that purchase prescription drugs to ensure compliance of a pharmacy benefits 
manager with the requirements of this section. 
The State Auditor shall develop 
appropriate audit procedures to be used by the State to detennine if a pharmacy benefits 
manager and a pharmacy benefits management contract entered into by the State meets 
the requirements of this section and other laws applicable to pharmacy benefits. 
Sec. 6. 22 MRS A §2699, sub-§9 is enacted to read: 
9. Privacy protections. The following provisions apply to the release of records 
containing individually identifying information. 
A. 
In addition to the disclosure and privacy prOVlSlons of the federal Health 
Insurance Portability and Accountability Act of 1996,42 United States Code, Section 
1301 et seq., a pharmacy benefits manager may not knowingly disclose or use records 
containing individually identifying information for marketing a prescribed product to 
a patient or prescriber. 
B. A record containing individually identifying information may be transferred to 
another entity, including to another branch or subsidiary of the same firm, only if 
there is satisfactory assurance that the recipient will safeguard the records from being 
disclosed or used in the State for a marketing purpose prohibited under this section. 
C. Records containing individually identifying information may be disclosed, sold, 
transferred, exchanged or used for nonmarketing purposes. 
D. This section does not prohibit conduct involving the collection, use, transfer or 
sale of records for marketing purposes if: 
(1) The data in the records is aggregated; 
(2) The data in the records does not contain individually identifying information; 
and 
(3) There is no reasonable basis for the belief that the data in the records can be 
used to obtain individually identifying information. 
E. This section may not prevent a person from disclosing records to the identified 
individual as long as the information does not include individually identifying 
information pertaining to another person. 
SUMMARY 
This bill requires pharmacy benefits managers to register with the Department of 
Professional and Financial Regulation, Bureau of Insurance before entering into any 
contracts for pharmacy benefits management in the State. 
The bill also sets forth 
standards for audits conducted by pharmacy benefits managers. The bill requires the 
State Auditor to develop audit procedures to ensure state agencies that have pharmacy 
benefits management contracts are compliant with state law relating to pharmacy benefits 
management and prescription drug rebates. The bill also expands the privacy provisions 
applicable to pharmacy benefits managers to ensure that patient prescription information, 
even deidentified information, is not used directly by the pharmacy benefits manager or 
sold by or transferred to others for use in phannaceutical marketing or by insurance 
companies in making benefits decisions. 
) 
\ 
,) 
)