November 1, 2005, Introduced by Reps. Dillon, Tobocman, Alma Smith, Gleason, Zelenko, Vagnozzi, Adamini, Gaffney, Condino, Leland, Bieda, Meisner, Gillard, Ball, Angerer and Kolb and referred to the Committee on Health Policy.
A bill to establish an intrastate prescription drug purchasing
cooperative; to implement a bulk purchasing program; to establish a
prescription drug benefit plan for certain residents of this state;
to prescribe certain powers and duties of certain state agencies
and departments; and to provide for the promulgation of rules.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 1. This act shall be known and may be cited as the
"Michigan prescription gold benefit plan".
Sec. 3. As used in this act:
(a) "Cooperative" means the intrastate prescription drug
purchasing cooperative established under section 5.
(b) "Department" means the department of management and
budget.
(c) "Participating retail pharmacy" means a pharmacy or other
business that dispenses prescription drugs at retail and is
licensed under article 15 of the public health code, 1978 PA 368,
MCL 333.16101 to 333.18838, that voluntarily agrees to dispense
prescription drugs covered by a discount or rebate agreement under
the Michigan prescription gold benefit plan established under
section 7.
(d) "Underinsured" means an individual who is covered by a
health insurance policy or certificate, health maintenance
organization contract, health care corporation certificate, or
other health care payment or benefits plan, which policy,
certificate, contract, or plan pays 80% or less of prescription
drug costs.
Sec. 5. (1) The department shall establish an intrastate
prescription drug purchasing cooperative. The cooperative shall be
composed of a representative from each agency or department that
administers a program funded in whole or in part by the state that
provides pharmaceutical benefits for, including, but not limited
to, state employees, retirees, teachers, elders, or prisoners. Any
entity that provides prescription drugs either directly or through
some form of coverage to residents of this state may voluntarily
elect to become a member of the cooperative and combine its
purchasing power with the state's.
(2) Except as otherwise provided under this subsection, to
maximize the state's purchasing power and reduce the costs of
prescription drugs, the cooperative shall combine the
pharmaceutical purchasing power from each department or agency
described under subsection (1) and from each entity that elects to
join the cooperative. If the cooperative determines that approval
by the center for medicare and medicaid services is required before
combining the purchasing power of certain programs, then those
programs may be exempt from participation in the purchasing
cooperative until such approval has been granted.
(3) The cooperative shall issue a request for proposal for a
pharmacy benefits manager to service the multiple programs covered
under the cooperative and to negotiate for discounts and rebates
with the aggregate purchasing power of the cooperative. The request
for proposal may include the administration of some or all of the
cooperative's various pharmaceutical programs and the Michigan
prescription gold benefit plan established under section 7.
Sec. 7. (1) Based on the savings realized by combining the
state's purchasing power and the purchasing power of those entities
in the private sector that wish to join the cooperative, the
department shall establish the Michigan prescription gold benefit
plan to provide accessible and affordable prescription drugs to the
uninsured and underinsured residents of this state.
(2) The Michigan prescription gold benefit plan is available
to any resident of this state who does not have prescription drug
coverage under a health insurance policy or certificate, health
maintenance organization contract, health care corporation
certificate, or other public or private health care payment or
benefits plan or is underinsured. To enroll in this plan, an
individual shall pay a $25.00 annual enrollment fee. Families of 4
or more individuals may enroll by paying a $75.00 annual enrollment
fee.
(3) Under the Michigan prescription gold benefit plan, the
discounts and rebates negotiated and offered to the state for
certain prescription drugs under the cooperative's various
pharmaceutical programs are extended to all residents enrolled in
the plan through any participating retail pharmacy.
Sec. 9. The department may promulgate rules pursuant to the
administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to
24.328, that are necessary to implement this act, including, but
not limited to, rules regarding the operation and application of
the prescription gold benefit plan and procedures for issuing
enrollment cards for that plan.