| | |
(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; |
|
|