Rx

Colorado and Michigan have joined Oklahoma to become the nation’s pioneering states with approved State Plan Amendments (SPAs) that enable Medicaid alternative payment models (APMs) for prescription drugs in the form of outcome-based contracts with pharmaceutical manufacturers. In early May, state experts from Oklahoma, Colorado, and Michigan shared their experiences implementing their APMs during a […]

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  • State Health Policy Blog

    Delaware Takes on High Prescription Drug Costs by Leveraging Public Purchasers

    Delaware’s state Legislature has established the Interagency Pharmaceuticals Purchasing Study Group to recommend steps to leverage bulk purchasing of drugs to effectively negotiate lower prices by using interagency and multistate purchasing contracts, and other approaches. The measure easily passed the House on a voice vote and unanimously passed the Senate. The study group has an […]

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  • State Health Policy Blog

    New Law Enables New Mexico to Leverage State Purchasing Power to Lower Rx Spending

    New Mexico Gov. Lujan Grisham recently signed into law SB 131, establishing a state Interagency Pharmacy Purchasing Council to leverage public purchasing power by reviewing and coordinating cost-containment strategies through procurement of pharmaceuticals, pharmaceutical benefits, and pooling of risk among state agencies. Cosponsored by state Sen. Jeff Steinborn* and Rep. Joanne Farrary, the law also […]

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  • State Health Policy Blog

    Maryland Passes Nation’s First Prescription Drug Affordability Board Legislation

    On April 8, 2019, the Maryland General Assembly passed legislation that which would create the first state Prescription Drug Affordability Board (PDAB) to address the costs of certain high-priced drugs in Maryland. Gov. Larry Hogan has until May 31, 2019, to sign or veto the bill. If he signs the bill or does nothing, the […]

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  • Publications

    Cross-Agency Strategies to Curb Health Care Costs: Leveraging State Purchasing Power

    Rising health care costs are an intractable problem in the United States, but states, faced with balanced budget requirements and growing voter concern, aren’t waiting for a federal solution. This report explores state initiatives to curb health care costs by:  Leveraging Medicare’s well-established reimbursement rates as reference prices for state employee plans to address rising […]

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  • State Health Policy Blog

    State Legislatures Examine Proposals to Curb Rx Drug Costs

    Recent legislative committee hearings in Maryland, Florida, and Illinois provide a national snapshot of states’ diverse and innovative proposals to reign in drug costs. Maryland’s drug affordability review board: Earlier this month, Maryland’s House Health and Government Operations Committee and Senate Finance Committee held lengthy hearings on an innovative bill that creates a state prescription […]

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  • State Health Policy Blog

    Colorado Develops New Payment Method for Physician-Administered Drugs – with the Potential to Save Millions

    The National Academy for State Health Policy (NASHP) provided a grant to the Colorado Department of Health Care Policy and Financing to develop a new payment methodology for physician-administered drugs (PADs). PADs are drugs delivered by intravenous infusion or injection in clinical settings. The category includes costly drugs, such as chemotherapy and other specialty medications. […]

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  • State Health Policy Blog

    Highlights of States’ ‘Surprise’ Medical Balance Billing Laws

    Surprise balance bills occur when patients receive unanticipated charges for health care services because they were unaware that care was delivered by an out-of-network provider or facility. In some cases, surprise balance bills can amount to hundreds if not thousands of dollars in medical expenses. A growing number of states have passed or are proposing […]

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  • Comparison of Bills Creating State Prescription Drug Affordability Review Boards

    A growing number of states are considering legislation to create prescription drug affordability review boards during the 2019 session. These boards would enable states to set “allowable rates” for certain high-cost drugs identified by the board, similar to the approach states use to regulate utilities or insurance premiums. NASHP released drug affordability review board model […]

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  • State Health Policy Blog

    Montana Explores a New Approach to Regulating Pharmacy Benefit Managers

    State legislatures across the country continue efforts to address the opaque business practices of pharmacy benefit managers (PBMs) to protect consumers and lower prescription drug prices. Montana is taking a new approach by leveraging its insurance department’s regulatory authority over insurance carriers by proposing a bill that tasks insurers with responsibility for overseeing that PBMs […]

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