House File 3266 Summary

• Sets pharmacy dispensing fee at $3.65, with higher fees for intravenous solutions ($8 per bag), cancer chemotherapy ($14 per bag), and parenteral nutritional products ($30 per bag for one liter or less, $44 per bag for greater than one liter).

• Establishes drug acquisition cost estimation effective July 1, 2009, at average wholesale price minus 15 percent for regular drugs and minus 30 percent for antihemophilic factor drugs.

• Creates special reimbursement formula for drugs covered by New England Carpenters Health Benefits Fund v. First Data Bank settlement at average wholesale price minus 11.46 percent or cost plus 6.25 percent, whichever provides equivalent reimbursement rate that was in effect prior to settlement agreement.

• Allows additional $0.30 dispensing fee for legend drug prescriptions to long-term care facility residents using unit dose blister card systems approved by the department, with 30-day supply requirement and National Drug Code identification on claims.

• Authorizes commissioner to negotiate lower reimbursement rates for specialty pharmacy products used in treating complex chronic diseases and to require enrollees to obtain such products from designated providers.