An Act to Improve Access to Affordable Prescription Drugs in Underserved Areas
Maine Legislature, Session 131, LD 2175
Committee: Health Coverage, Insurance and Financial Services
Sponsors: JACKSON, TALBOT ROSS, BAILEY, CURRY, HICKMAN, NANGLE, RENY, TIPPING, ARFORD, PERRY
Amends: 22 MRSA §259

Legislative Document
No. 2175
S.P. 926
In Senate, January 22, 2024
An Act to Improve Access to Affordable Prescription Drugs in 
Underserved Areas
(EMERGENCY)
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203.
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by President JACKSON of Aroostook.
Cosponsored by Speaker TALBOT ROSS of Portland and
Senators: BAILEY of York, CURRY of Waldo, HICKMAN of Kennebec, NANGLE of 
Cumberland, RENY of Lincoln, TIPPING of Penobscot, Representatives: ARFORD of 
Brunswick, PERRY of Calais.
Emergency preamble.  Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, the federal drug pricing program under Section 340B of the federal Public 
Health Service Act, 42 United States Code, Section 256b requires prescription drug 
manufacturers to offer discounted pricing to certain covered entities, including federally 
qualified health centers; and
Whereas, federally qualified health centers serve rural and other underserved areas, 
delivering health care that would otherwise be inaccessible to residents of such areas; and
Whereas, a crucial part of such care is the provision of life-saving prescription drugs 
at affordable prices made possible by the 340B program, which also generates savings that 
federally qualified health centers must, as a matter of mission and federal law, use to reduce 
costs and improve access to services for patients of those health centers; and
Whereas, prescription drug manufacturers have recently imposed conflicting and 
burdensome requirements for covered entities to obtain discounted pricing under the 340B 
program, depriving patients of access to affordable prescription drugs under the 340B 
program; and
Whereas, the number of retail pharmacies and the hours of operation of retail 
pharmacies in underserved areas of the State have been dramatically reduced in recent years 
due to workforce challenges and other economic challenges; and
Whereas, federally qualified health centers can compensate for the decline in 
availability of retail pharmacies and for the restrictive practices of prescription drug 
manufacturers only by developing or expanding their capacity to provide retail pharmacy 
services as part of their health center services, yet existing health center revenues and 
resources are insufficient to support such development and expansion; and
Whereas, it is therefore essential to provide immediate funding support for federally 
qualified health centers to develop and expand retail pharmacy capacity in this State to 
address the critical shortage of access to affordable prescription drugs; 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,
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §259, sub-§1, ¶B, as amended by PL 2015, c. 267, Pt. JJJ, §1, 
is further amended to read:
B.  Six hundred ninety-nine thousand, one hundred fifty dollars in fiscal year 2001-02 
to federally qualified health centers to support the infrastructure of these programs in 
providing primary care services to underserved populations.  Forty-four thousand, two 
hundred fifty dollars must be provided to each federally qualified health center with an 
additional $8,850 for the 2nd and each additional site operated by a federally qualified 
health center.  For the purposes of this paragraph, "site" means a site or sites operated 
by the federally qualified health center within its scope of service that meet all health 
center requirements, including providing primary care services, regardless of patients' 
ability to pay, 5 days a week with extended hours.  If there is not sufficient funding to 
meet the formula in this paragraph, the $699,150 must be allocated in proportion to the 
formula outlined in this paragraph; and
Sec. 2.  22 MRSA §259, sub-§1, ¶C, as enacted by PL 2015, c. 267, Pt. JJJ, §1, is 
amended to read:
C.  Five hundred thousand dollars, beginning with fiscal year 2015-16 and continuing 
each fiscal year thereafter, to support access to primary medical, behavioral health and 
dental services to residents of the State in rural and underserved communities and to 
assist with provider recruitment and retention.  Twenty-five thousand dollars must be 
provided to each federally qualified health center.; and
Sec. 3.  22 MRSA §259, sub-§1, ¶D is enacted to read:
D.  Seven million five hundred thousand dollars in fiscal year 2024-25 to support access 
to pharmacy services and affordably priced prescription drugs to residents of the State 
in rural and underserved communities by providing funds to support federally qualified 
health centers in developing or improving pharmacy services, including without 
limitation:
(1) Planning, designing, constructing and operating one or more licensed retail 
pharmacies as part of a federally qualified health center's services; 
(2) Entering into arrangements, including with one or more federally qualified 
health centers, to expand the availability of prescription drugs purchased and 
delivered to patients under the federal drug pricing program under Section 340B 
of the federal Public Health Service Act, 42 United States Code, Section 256b; and 
(3) Expanding access to prescription drugs supplied by one or more federally 
qualified health centers, including without limitation by increasing the number of 
locations from which patients may obtain prescription drugs, improving existing 
pharmacy facilities, expanding the availability of automated pharmacy systems as 
defined in Title 32, section 13702-A, subsection 1 or addressing workforce issues 
related to pharmacy program planning and operation.
Sec. 4.  22 MRSA §259, sub-§3 is enacted to read:
3.  Allocation of pharmacy services support funding.  Each federally qualified health 
center may apply for funds made available pursuant to subsection 1, paragraph D by 
providing the Office of Affordable Health Care, as established in Title 5, section 3122, with 
a budget and plan for developing or improving pharmacy services and access to affordably 
priced prescription drugs for its patients.  The Office of Affordable Health Care shall 
allocate available funds equitably among all applicants based on the cost-effectiveness and 
feasibility of the proposed development or improvement of patient access to affordably 
priced prescription drugs.  In developing criteria for awarding available funds, the Office 
of Affordable Health Care shall consult with and consider the recommendations of a 
statewide association of federally qualified health centers. Any available funds not awarded 
in fiscal year 2024-25 must be deposited in a nonlapsing account from which awards may 
be made in subsequent fiscal periods for the purposes set forth in subsection 1, paragraph 
D.
Sec. 5.  Implementation.  The Office of Affordable Health Care, as established in 
the Maine Revised Statutes, Title 5, section 3122, shall publish a schedule and instructions 
for the content of applications and criteria for determining awards for the pharmacy 
services support program described in this legislation.  The Office of Affordable Health 
Care's schedule must ensure that initial awards of funding be made no later than December 
15, 2024 and must ensure that applicants have no less than 60 days to prepare and submit 
applications after instructions for the content of applications and criteria for selection have 
been published. Notwithstanding any provision of law to the contrary, the Office of 
Affordable Health Care shall ensure that a majority of the persons selected to evaluate the 
applications have substantial training or experience in the operation and management of a 
federally qualified health center, by including among those evaluating the applications 
volunteers recommended by a statewide association of federally qualified health centers.
Sec. 6.  Change in scope adjustment.  Upon issuance of each award pursuant to 
the Maine Revised Statutes, Title 22, section 259, subsection 3, the Office of Affordable 
Health Care, as established in Title 5, section 3122, shall promptly implement a change in 
scope adjustment pursuant to Title 22, section 3174-V, subsection 4 to reflect the ongoing 
costs for the federally qualified health center receiving the grant to reflect the ongoing costs 
of operating expanded or improved pharmacy services.
Sec. 7.  Appropriations and allocations.  The following appropriations and 
allocations are made.
OFFICE OF AFFORDABLE HEALTH CARE
Office of Affordable Health Care Z320
Initiative: Provides one-time funding for the Office of Affordable Health Care to support 
federally qualified health centers in developing and expanding pharmacy services and 
access to affordably priced prescription drugs for the patients of such health centers.
GENERAL FUND
2023-24
2024-25
All Other
$0
$7,500,000
__________
__________
GENERAL FUND TOTAL
$0
$7,500,000
Emergency clause.  In view of the emergency cited in the preamble, this legislation 
takes effect when approved.
SUMMARY
This bill directs the Office of Affordable Health Care to provide support for federally 
qualified health centers to develop or expand the centers' capacity to provide access to 
affordably priced prescription drugs to patients by increasing the centers' ability to deliver 
pharmacy services to those patients.  The bill appropriates $7,500,000 in fiscal year 2024-
for that purpose. The bill provides that initial awards of support must be made by 
December 15, 2024 and that the selection process must be performed by an evaluation 
team, the majority of whose members must be persons experienced in the operation and 
management of federally qualified health centers.