Introduced by Representatives Tracy of Burlington, Trombley of Grand Isle, Bohi of Hartford, Botzow of Pownal, Brooks of Montpelier, Chen of Mendon, Connell of Warren, Cross of Winooski, Donovan of Burlington, Edwards of Brattleboro, Fisher of Lincoln, Gervais of Enosburg, Jewett of Ripton, Johnson of South Hero, Kenyon of Bradford, Klein of East Montpelier, Larson of Burlington, Maier of Middlebury, McLaughlin of Royalton, Milkey of Brattleboro, Nease of Johnson, Nuovo of Middlebury, Partridge of Windham, Pillsbury of Brattleboro, Pugh of South Burlington, Shand of Weathersfield, Sharpe of Bristol, Smith of Morristown and Sweaney of Windsor
Subject: Health; prescription drugs; reimportation
Statement of purpose: This bill directs the department of prevention, assistance, transition, and health access (PATH) to establish a program to provide for and facilitate the purchase of prescription drugs from Canada.
AN ACT RELATING TO THE PURCHASE OF PRESCRIPTION DRUGS FROM CANADA
It is hereby enacted by the General Assembly of the State of Vermont:
Sec. 1. 33 V.S.A. §§ 2007 and 2008 are added to read:
§ 2007. CITIZENS’ PRESCRIPTION DRUG PURCHASING PROGRAM FROM CANADA
(a) On or before January 1, 2005, the department of prevention, assistance, transition, and health access shall establish a program to enable Vermont residents, including Medicaid recipients, to purchase from Canada prescription drugs manufactured in the United States. For the purposes of this section, “Medicaid recipients” includes any individual who participates in Medicaid or any Medicaid waiver program, including the Vermont health access plan, Dr. Dynasaur, Healthy Vermonters, VHAP pharmacy, VScript or
(b) The program shall provide:
(1) information, including drug pricing, about procuring from Canadian sources prescription drugs manufactured in the United States through the mail, from local pharmacies, or otherwise; and
(2) the necessary forms and contact information for procuring from Canadian sources prescription drugs manufactured in the United States.
(c) The department shall establish a website and provide written information regarding the program.
(d) The commissioner shall offer a request for proposals to prescription drug wholesalers whose primary place of business is in Vermont to participate in the program. The commissioner shall offer a $10.00 transaction fee for any pharmacy who elects to participate in the program whose primary place of business is in Vermont.
(e) If no wholesaler elects to participate, the commissioner shall set up a program directly with Canadian sources. The commissioner shall:
(1) offer a request for proposals directly to Canadian sources soliciting physicians and pharmacies who wish to participate in the program;
(2) appoint a panel of health care professionals, including at least two physicians, two pharmacists, and one member each of the professional conduct boards for physicians and pharmacists to investigate and review the proposals to ensure that the Canadian sources are safe;
(3) require that any participating physicians or pharmacists be licensed by a Canadian province whose licensing requirements are deemed to be substantially equal to those of this state;
(4) establish a relationship with at least one Canadian physician to prescribe the medication in conjunction with the Vermont resident’s physician and at least five Canadian pharmacies to allow consumers a choice of pharmacy.
(f) The commissioner may implement the prescription drug purchasing program for any other health benefit plan within or outside this state that agrees to participate in the program. The commissioner shall work with the commissioners of corrections, developmental disabilities and mental health services, and personnel to establish the state prescription drug purchasing program authorized in section 2008 of this title.
(g) The commissioner shall adopt rules as necessary to allow participants in the Medicaid and Medicare programs to apply the costs of prescription drugs purchased outside this country toward any deductibles or spend-down amounts required by those programs.
§ 2008. STATE PRESCRIPTION DRUG PURCHASING PROGRAM
(a) The commissioners of prevention, assistance, transition, and health access; corrections; developmental disabilities and mental health services; and personnel shall negotiate for the purchase from Canadian sources of prescription drugs manufactured in the United States so that individuals under the supervision of the department of corrections, individuals under the supervision of the department of developmental disabilities and mental health services, and beneficiaries of a health benefit plan, as defined in subdivision 1997(4) of this subchapter, covering employees, including retirees, who have a valid prescription, may procure prescription drugs at reduced prices.
(b) The commissioners shall offer a request for proposals to prescription drug wholesalers whose primary place of business is in Vermont to procure from Canadian sources the prescription drugs manufactured in the United States. If no wholesaler participates, the commissioners shall negotiate directly with Canadian sources.
(c) The commissioner of personnel shall offer a financial incentive for state employees and retirees who purchase prescription drugs through the state prescription drug program established by the section.
(d) A municipality or school board may negotiate for the purchase from Canadian sources of prescription drugs manufactured in the United States so that beneficiaries of a health benefit plan, as defined in subdivision 1997(4) of this subchapter, covering employees, including retirees, who have a valid prescription may procure prescription drugs at reduced prices.
(e) This section does not limit collective bargaining on employee benefits pursuant to 3 V.S.A. § 904, 16 V.S.A. § 1981, or 21 V.S.A. § 1725.
Sec. 2. 33 V.S.A. § 1998(a)(1) is amended to read:
§ 1998. PHARMACY BEST PRACTICES AND COST CONTROL
(a) The commissioner of prevention, assistance, transition, and health access shall establish a pharmacy best practices and cost control program designed to reduce the cost of providing prescription drugs, while maintaining high quality in prescription drug therapies. The program shall include:
(1) A preferred list of covered prescription drugs that identifies preferred choices within therapeutic classes for particular diseases and conditions, including generic alternatives. Any brand-name prescription drug made by a company that limits its supply of prescription drugs to Canada shall not be included on the preferred list if a safe, equivalent drug is otherwise available.
Sec. 3. 8 V.S.A. § 4089i is added to read:
§ 4089i. PRESCRIPTION DRUG COVERAGE
(a) A health insurance or other health benefit plan offered by a health insurer shall count the costs of prescription drugs purchased outside this country toward any deductibles on the same terms and conditions as prescription drugs purchased in this country.
(b) As used in this section, “health insurer” is defined by subdivision 9402(9) of Title 18.
Sec. 4. 26 V.S.A. § 2042(b) is amended to read:
(b) The board may license by endorsement an applicant who is licensed under the laws of another state or a province of Canada whose requirements the board deems to be substantially equal to those of this state.
Sec. 5. RECODIFICATION DIRECTIVE
It is the intent of the general assembly to retain without modification the substantive provisions of 8 V.S.A. § 4089i, relating to “health care ombudsman,” as existed prior to this act. It is also the intent of the general assembly to add provisions relating to prescription drug coverage to subchapter 1 of chapter 107 of Title 8, relating to health insurance generally. Therefore, the legislative council, pursuant to its revision authority in 2 V.S.A. § 424, is directed to recodify 8 V.S.A. §§ 4089i and 4089j to be 8 V.S.A. §§ 4089v and 4089w, respectively, or other recodification or renumbering the legislative council deems appropriate, to retain without change those sections as a separate subchapter 1A of chapter 107 of Title 8 pertaining to “Health Care Ombudsman.” The substantive provisions of Sec. 3 of this act relating to prescription drug coverage shall be codified as part of subchapter 1 of chapter 107 of Title 8, to be designated as section 4089i of Title 8, or other numeration as determined by the legislative council.
Sec. 6. EFFECTIVE DATE; APPLICABILITY
This act shall take effect July 1, 2004, except that the provisions of Sec. 2 of this act, relating to the pharmacy best practices control program, shall apply to health benefit plans as they are offered, issued, or renewed after July 1, 2004, but in no event later than January 1, 2005.
The Vermont General Assembly
115 State Street