An Act to Enhance Cost Savings to Consumers of Prescription Drugs
Maine Legislature, Session 131, LD 1165
Committee Amendment CA_A_H780 (House)
Amends: 24-A MRSA §4350-A

COMMITTEE AMENDMENT "(^ " to H.P. 737, L.D. 1165, "An Act to Enhance
Cost Savings to Consumers of Prescription Drugs"
Amend the bill by striking out everything after the enactmg clause and inserting the
following;
'See. 1. 24-A MRSA §4350-A, as enacted by PL 2019,c.469,§8 and affected by
§9, is amended to read;
§4350-A. Responsibility to use compensation for benefit of covered persons
1. Compensation used to reduce point-of-sale costs, improve benefits or lower
premiums. All compensation remitted by or on behalf of a pharmaceutical manufacturer,
developer or labeler, directly or indirectly, to a carrier, or to a pharmacy benefits manager
under contract with a carrier, related to its prescription drug benefits must be:
A. Remitted directly to the covered person at the point of sale to reduce the out of
pocket cost to the covered person associated with a particular prescription drug covered
person's cost-sharing amount for a particular prescriptiQ^^^ up to at
least 100% of all compensation remitted under this subsection in connection with the
disoensme or administration of that dme; e? Mid
B, Remitted Fpr^anv compensatio^m^^^^ amount required to be remitted to
a covered person at the point of sale pursuant to paragraph A. remitted to, and retained
by, the carrier. Compensation remitted to the carrier must be applied by the carrier in
its plan design and in future plan years to offset the premium for covered persons.
2. Compliance. Bogmning March 1,2021 and annually thoreufter Annually, by March
1st. a carrier shall file with the superintendent a report in the manner and form determined
by the superintendent demonstrating how the carrier has complied with this section^
includine information on the number of covered personsthe carrier has remitted
compensation to at the tioint of sale and the amount of that compensation,
Sec. 2. Appropriations and allocations. The followmg appropriations and
allocations are made,
COMMITTEE AMENDMENT
?p''/
COMMITTEE AMENDMENT " }\ " to H.P. 737, L.D, 1165
ADMINISTRATIVE AND FINANCIAL SERVICES, DEPARTMENT OF
Departments and Agencies - Statewide 0016
Initiative: Provides funding for the new requirement that compensation remitted by or on
behalf of a pharmaceutical manufacturer, developer or labeler to a pharmacy benefits
manager be remitted first to the covered person at the point of sale up to the amount of any
cost sharing associated with a prescription drug and then any remaining amount must be
remitted to and retained by a carrier to offset health insurance premium costs.
GENERAL FUND 2023-24 2024-25
AHOther $0 $902,971
GENERAL FUND TOTAL $0 $902,971
HIGHWAY FUND 2023-24 2024-25
AllOther $0 $333,256
HIGHWAY FUND TOTAL $0 $333,256
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section
number to read consecutively.
SUMMARY
This amendment is the minority report of the committee and replaces the bill. The
amendment requires that compensation remitted by or on behalf of a pharmaceutical
manufacturer, developer or labeler to a pharmacy benefits manager be remitted first to the
covered person at the point of sale up to the amount of any cost sharing associated with a
prescription drug and then any remaining amount must be remitted to and retained by a
carrier to offset health insurance premium costs.
The amendment requires that the information reported by carriers in their annual report
related to compensation include information about the number of covered persons that have
received compensation from the carrier for their out-of-pocket costs and the amount of that
compensation.
The amendment also adds an appropriations and allocations section to provide funding
for the requirement that any compensation be remitted first to the covered person at the
point of sale.
FISCAL NOTE REQUIRED
(See attached)
COMMITTEE AMENDMENT
Approved: 02/09/24 ^«c^
LD 1165 LR 729(02)
An Act to Enhance Cost Savings to Consumers of Prescription Drugs
Fiscal Note for Bill as Amended by Committee Amendment "|^-' (\-\^
Committee: Health Coverage, Insurance and Financial Services
Fiscal Note Required: Yes,
Fiscal Note
FY 2023-24
$0
$0
$0
$0
FY 2024-25
$902,971
$333,256
$902,971
$333,256
Projections
FY 2025-26
$902,971
$333,256
$902,971
$333,256
Projections
FY 2026-27
$902,971
$333,256
$902,971
$333,256
Net Cost (Savings)
General Fund
Highway Fund
Appropriations/Allocations
General Fund
Highway Fund
Fiscal Detail and Notes
This bill impacts the State Employee Health Plan by requiring that compensation remitted by or on behalf of a
pharmaceutical manufacturer, developer or labeler to a pharmacy benefits manager be remitted first to the covered
person at the point-of-sale up to the amount of any cost sharing associated with a prescription drug and then any
remaining amount must be remitted to and retained by a carrier to offset health insurance premium costs. It is
expected that this change will take effect on or after July 1,2024. The total cost to the plan is estimated to be
$2,000,000 in fiscal year 2024-25. The bill includes General Fund appropriations of $902,971 in fiscal year 2024-25
and Highway Fund allocations of $333,256 in fiscal year 2024-25 for state departments and agencies that pay
premiums to the State Employee Health Plan to cover the increased costs for those two funds. The remaining costs of
$763,773 in fiscal year 2024-25 will be distributed across multiple funds across state government,
Any additional costs to the Department of Professional and Financial Regulation associated with the provisions of
this bill are expected to be minor and can be absorbed within existing budgeted resources, The collection of
additional fines may increase other dedicated revenue by minor amounts,
LR0729(02) - Fiscal Note - Page 1 of 1