STAND. COM. REP. NO. 1045

Honolulu, Hawaii

RE:    H.B. No. 252

       H.D. 1

       S.D. 1

Honorable Donna Mercado Kim

President of the Senate

Twenty-Eighth State Legislature

Regular Session of 2015

State of Hawaii

Madam:

     Your Committee on Health, to which was referred H.B. No. 252, H.D. 1, entitled:

"A BILL FOR AN ACT RELATING TO PHARMACY BENEFIT MANAGERS,"

begs leave to report as follows:

     The purpose and intent of this measure is to:

     (1)  Establish requirements for a pharmacy benefit manager that reimburses a contracting pharmacy for a drug on a maximum allowable cost basis; and

     (2)  Require the pharmacy benefit manager to have a clearly defined process for a contracting pharmacy to appeal the maximum allowable cost for a drug on a maximum allowable cost list and establish requirements for that process.

     Your Committee received testimony in support of this measure from the Hawaii Community Pharmacists Association and one individual.  Your Committee received comments on this measure from CVS Health.

     Your Committee finds that the majority of daily claims that a pharmacy fills are generic drugs and that there is currently no legal process regarding the maximum allowable cost appeal process.  This measure sets parameters for pharmacy benefit managers to establish such a process.

     Your Committee has amended this measure by:

     (1)  Specifying that a contracting pharmacy shall be provided no less than fourteen business days following receipt of payment for the claim upon which the appeal is based to file the appeal with the pharmacy benefit manager, rather than pay the claim; and

     (2)  Making technical, nonsubstantive amendments for the purposes of clarity and consistency.

     As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 252, H.D. 1, as amended herein, and recommends that it pass Second Reading in the form attached hereto as H.B. No. 252, H.D. 1, S.D. 1, and be referred to the Committees on Commerce and Consumer Protection and Ways and Means.

Respectfully submitted on behalf of the members of the Committee on Health,

________________________________

JOSH GREEN, Chair