An Act To Improve the Quality and Reduce the Cost of Health Care
Maine Legislature, Session 125, LD 1364
Committee: Health and Human Services
Sponsors: FITTS, RAYE, CAIN, CUSHING, FOSTER, STRANG BURGESS, WINTLE, BRANNIGAN, PLOWMAN
Amends: 22 MRSA §3174-Q

Legislative Document 
No. 1364 
H.P. 1003 
House of Representatives, March 30, 2011 
An Act To Improve the Quality and Reduce the Cost of Health Care 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative FITTS of Pittsfield. 
Cosponsored by President RAYE of Washington and 
Representatives: CAIN of Orono, CUSHING of Hampden, FOSTER of Augusta, STRANG 
BURGESS of Cumberland, WINTLE of Garland, Senators: BRANNIGAN of Cumberland, 
PLOWMAN of Penobscot. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §3174-QQ is enacted to read: 
§3174-QQ.  Pharmaceuticals purchased through 340B covered entities 
Beginning January 1, 2012, the department shall coordinate the purchase of 
prescription drugs for MaineCare members through 340B covered entities in order for the 
MaineCare program to negotiate the lowest possible prices and avoid retail markup as 
provided in this section. 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "340B covered entity" means an organization eligible for prescription drug 
discounts under Section 340B of the federal Public Health Service Act, 42 United 
States Code, Section 256b (1999).  "340B covered entity" includes but is not limited 
to a federally qualified health center, federally qualified health center look-alike, as 
defined by the United States Department of Health and Human Services, critical 
access hospital and hospital eligible as a disproportionate share hospital. 
B.  "Prescription drug" has the same meaning as in Title 32, section 13702-A, 
subsection 30. 
2.  Calculation and distribution of savings.  The department shall work with 340B 
covered entities that are participating in the MaineCare program under this section and 
the United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services to calculate on a quarterly basis the savings attributable to purchasing 
prescription drugs under this section as compared to the net cost after all applicable 
rebates that would be paid if the department had not been able to purchase under this 
section. 
Of any savings recognized pursuant to this subsection, 75% must be retained by the 
department. The remaining 25% must be distributed by the department on a quarterly 
basis in the following priority. 
A.  As the first priority, federally qualified health centers and federally qualified 
health center look-alikes must be reimbursed for copayments due under section 
3173-C, subsection 7, paragraphs R and S but not paid by the member. 
B.  As the 2nd priority, the savings must be used by the department to invest in new 
or existing initiatives to improve the quality of health care as follows: 
(1)  The department shall direct the first $400,000 under this paragraph to a 
statewide association representing federally qualified health centers to assist the 
centers in achieving accreditation as patient-centered medical homes; and 
(2)  The department shall direct up to the next $250,000 to improve medication 
management and safety as follows: 
(a)  The department shall direct up to $150,000 under this division to 
sponsors of multidisciplinary teams in a patient safety pharmacy 
collaborative under the directive of the United States Department of Health 
and Human Services, Health Resources and Services Administration, based 
on criteria developed by the department after consultation with associations 
representing federally qualified health centers, hospitals, pharmacies, 
pharmacists, home health agencies and other entities providing health care; 
and 
(b)  The department shall direct up to $100,000 under this division to 2 
sponsors of demonstration projects in medication therapy management in 
which pharmacies collaborate with 340B covered entities, based on criteria 
developed by the department after consultation with associations representing 
federally qualified health centers, pharmacies and pharmacists. 
C.  As the 3rd priority, the savings must be used by the department to support 
employees of federally qualified health centers who perform eligibility functions for 
the department under contract in an amount up to $400,000. 
D.  As the 4th priority, the department shall use the balance to support federally 
qualified health centers for sponsorship of a program to expand access to preventive 
and primary care in underserved areas through assistance with applying for federal 
funding to establish a federally qualified health center or financial support for 
existing federally qualified health centers. 
3.  Exemption.  If the department determines that, for a particular named prescription 
drug, purchase through 340B covered entities will not produce any savings over purchase 
by another method, purchase through the 340B covered entity is not required. 
4.  Rulemaking.  The department shall adopt rules to implement this section.  Rules 
adopted under this subsection are routine technical rules as defined in Title 5, chapter 
375, subchapter 2-A. 
SUMMARY 
This bill directs the Department of Health and Human Services to coordinate the 
purchase of prescription drugs for MaineCare members through certain organizations 
eligible for prescription drug discounts under the federal Public Health Service Act, 
referred to as "340B covered entities," in order for the MaineCare program to negotiate 
the lowest possible prices and avoid retail markup beginning January 1, 2012.  The bill 
provides a mechanism to calculate savings from establishing the 340B program and 
distribute the savings among 340B covered entities.  The bill provides for routine 
technical rulemaking as required to implement the provisions of the bill.