An Act To Promote Transparency in the Medicaid Reimbursement Process
Maine Legislature, Session 125, LD 1485
Committee: Health and Human Services
Sponsors: FOSSEL, NUTTING, STRANG BURGESS, McCORMICK

Legislative Document 
No. 1485 
H.P. 1092 
House of Representatives, April 14, 2011 
An Act To Promote Transparency in the Medicaid Reimbursement 
Process 
(AFTER DEADLINE) 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
205. 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative FOSSEL of Alna. 
Cosponsored by Representatives: Speaker NUTTING of Oakland, STRANG BURGESS of 
Cumberland, Senator: McCORMICK of Kennebec. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA c. 603, sub-c. 1-B is enacted to read: 
SUBCHAPTER 1-B 
MAXIMUM ALLOWABLE COST LIST 
§2687.  Maximum allowable cost list 
1.  Comment period.  The Department of Health and Human Services, office of 
MaineCare services shall establish a 60-day written comment period on any proposed 
change to the state maximum allowable cost list if the change results in a reduction in 
payment to pharmacies.  The comment period may not occur more than quarterly.  The 
written comment period must be held in compliance with the Maine Administrative 
Procedure Act.  A change in the maximum allowable cost list that will result in a 
reduction in payment to pharmacies may not take effect until 90 days after the office of 
MaineCare services has completed its response to any written comments.  For the 
purposes of this section, "maximum allowable cost list" means a list of prescription drugs 
that bases reimbursement on the cost of the generic product. 
2.  Report.  The Department of Health and Human Services, office of MaineCare 
services shall prepare an annual report that summarizes the number of drugs affected by 
changes made to the maximum allowable cost list under subsection 1 and the percentage 
change in payment for those drugs that resulted from changes to the list during the 
calendar year.  The office of MaineCare services shall file the report annually by 
December 31st with the joint standing committee of the Legislature having jurisdiction 
over health and human services matters. 
3.  Rulemaking.  The Department of Health and Human Services, office of 
MaineCare services shall amend its rules to implement the provisions of this subchapter.  
Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A. 
SUMMARY 
This bill requires the Department of Health and Human Services, office of MaineCare 
services to establish a 60-day written comment period on any proposed change to the 
state maximum allowable cost list if the change results in a reduction in payment to 
pharmacies.  The office of MaineCare services is required to prepare an annual report that 
summarizes the number of drugs affected by such changes and the percentage change in 
payment for those drugs that resulted from changes to the list during the calendar year 
and submit that report annually by December 31st to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters.  The Department 
of Health and Human Services, office of MaineCare services is required to amend its 
rules to implement the provisions of this bill.