LD 468
pg. 309
Page 308 of 348 An Act Making Unified Appropriations and Allocations for the Expenditures of St... Page 310 of 348
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LR 2149
Item 1

 
(3)__The Maine School Management Association's health
insurance program; and

 
F.__ The director of the Governor's Office of Health Policy
and Finance or the director's designee or the director of a
successor agency.

 
2.__Chair and staff assistance.__The chair of the council is
the director of the Governor's Office of Health Policy and
Finance or the director's designee or the director of a successor
agency, who shall convene the council. The Governor's Office of
Health Policy and Finance or a successor agency shall provide
necessary staffing services to the council.

 
3.__Purpose.__The purpose of the council is to maximize the
cost effectiveness of the pharmaceutical benefit offered by all
health plans that are financed, in whole or in part, with public
dollars.__Other public purchasers not listed in subsection 1,
paragraph E and private purchasers may join the council to
participate in savings opportunities.

 
4.__Parameters of joint purchasing effort. The council shall
jointly purchase pharmaceuticals with the State in order to
reduce costs for all participating parties and maximize savings
by pooling purchasing power, but not to fundamentally alter the
independent nature of any of the health plans involved in the
council.__The joint purchasing effort must ensure:

 
A.__Each of the participating plans retains its distinct
nature, with members of each plan maintaining their current
medical coverage and participating organizations retaining
current contracts, except for amendments required to
implement the joint pharmaceutical purchasing effort;

 
B.__The members of participating plans have open access to
all prescription drugs; as medically needed, a 3-tiered
pharmaceutical benefit must be designed and implemented;

 
C.__Full coverage of certain drugs must be contingent upon
satisfaction of clinical criteria;

 
D.__A preferred drug list must identify clinically
efficacious, high-quality prescription drugs that are also
cost effective; these drugs may not require prior approval.
The preferred drug list must to the extent possible be based
on MaineCare's preferred drug list and must be advised by
MaineCare's clinical drug utilization committee;


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