BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 393|
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UNFINISHED BUSINESS
Bill No: SB 393
Author: Speier (D), et al
Amended: 9/7/99
Vote: 21
SENATE HEALTH AND HUMAN SERV. COMMITTEE : 5-2, 3/24/99
AYES: Escutia, Figueroa, Hughes, Polanco, Solis
NOES: Haynes, Mountjoy
NOT VOTING: Morrow, Vasconcellos
SENATE APPROPRIATIONS COMMITTEE : 12-0, 6/8/99
AYES: Alpert, Bowen, Burton, Escutia, Johnson, Karnette,
Kelley, Leslie, McPherson, Mountjoy, Perata, Vasconcellos
NOT VOTING: Johnston
SENATE FLOOR : 29-6, 6/10/99
AYES: Alarcon, Alpert, Baca, Bowen, Burton, Chesbro,
Costa, Dunn, Escutia, Figueroa, Hayden, Johnson,
Karnette, Kelley, Leslie, McPherson, Morrow, Mountjoy,
Murray, O'Connell, Ortiz, Peace, Polanco, Poochigian,
Rainey, Sher, Solis, Speier, Vasconcellos
NOES: Brulte, Haynes, Johannessen, Knight, Monteith,
Wright
NOT VOTING: Hughes, Johnston, Lewis, Perata, Schiff
ASSEMBLY FLOOR : 61-18, 9/10/99 - See last page for vote
SUBJECT : Prescription rates for Medicare beneficiaries
SOURCE : Author
CONTINUED
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DIGEST : This bill requires a pharmacy to use the Medi-Cal
reimbursement rate as the prescription price for a Medicare
beneficiary, and requires specified studies.
Assembly Amendments :
1. Add a sunset date of January 1, 2003.
2. Provide that the price charged to Medicare beneficiaries
shall not exceed the Medi-Cal reimbursement rate for
prescription medicines plus an amount to cover
electronic transmission charges.
3. Prevents Medicare beneficiaries from using the
reimbursement rate for over-the-counter medications or
compounded prescriptions.
4. Direct the Department of Health Services to monitor
pharmacy participation and report to the Legislature
annually.
ANALYSIS :
Existing Federal Law
1.Provides a national insurance program for people 65 years
of age and older, certain younger disabled people, and
people with permanent kidney failure under the Medicare
program.
2.Does not include outpatient prescription drug coverage
under Medicare.
Existing State Law
1.Provides for prescription drug benefits to Medi-Cal
beneficiaries, who are qualified low-income persons.
2.Allows the State Department of Health Services (DHS) to
enter into contracts with manufacturers of prescription
drugs, and requires DHS to maintain a contract drug list
for Medi-Cal reimbursement claims.
3.Requires DHS to ensure that there is sufficient
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representation of drugs in each major therapeutic
category on the contract drug list.
This bill:
1. Requires that, as a condition of a pharmacy's
participation in the Medi-Cal program, the price charged
to Medicare beneficiaries shall not exceed the Medi-Cal
reimbursement rate for prescription medicines plus an
amount to cover electronic transmission charges.
Requires the Department of Health Services (DHS) to
provide a mechanism to calculate and transmit the price
to the pharmacy.
2. Prevents Medicare beneficiaries from using the Medi-Cal
reimbursement rate for over-the-counter medications or
compounded prescriptions.
3. Directs DHS to monitor pharmacy participation and report
to the Legislature annually.
4. Requires the Senate Office of Research to report to the
Legislature if prescription drugs are added to the scope
of benefits available under the federal Medicare
program.
5. Directs DHS to conduct a study of the adequacy of
Medi-Cal pharmacy reimbursement rates including the cost
of providing prescription drugs and services.
Comments:
The author is concerned about Medicare beneficiaries who
cannot afford to pay for their medications. The author
points out that this bill would lower the cost of
prescription drugs for seniors. This bill targets Medicare
beneficiaries who comprise 12% of California's population
but use 33% of all the prescription drugs sold in the
state. The author also points out that many seniors are
being dumped by their health maintenance organizations
(HMOs), thereby losing pharmacy coverage. The author points
to studies and congressional reports which conclude that
many seniors without drug coverage are charged far more
(often double) than the amount drug companies charge their
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most favored customers, such as HMOs and government
agencies. The author points out that the issue of drug
coverage for seniors is so significant that national reform
legislation is under consideration. This bill calls for a
reevaluation of this program if prescription drugs are
added to benefits available under the federal Medicare
program.
Senior groups including AARP, the California Seniors
Coalition, Gray Panthers and the Older Women's League (Owl)
support this bill arguing that many seniors are unable to
afford their medications, leading to disastrous results
when they fail to take their medicine as prescribed. They
support this bill because it will reduce the costs of
prescription drugs for all Medicare beneficiaries. Owl also
supports this bill because it establishes a simple program
and is not needs based.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
Unknown
SUPPORT : (Verified 9/10/99)
AARP
California Nurses Association
Gray Panthers of Sacramento
Older Women's League
California Mental Health Directors Association
California Seniors Coalition
Nevada County Republican Women
California Retailers Association
ASSEMBLY FLOOR :
AYES: Aanestad, Alquist, Aroner, Bates, Battin, Bock,
Brewer, Calderon, Cardenas, Cardoza, Cedillo, Corbett,
Correa, Cunneen, Davis, Dickerson, Ducheny, Dutra,
Firebaugh, Florez, Gallegos, Granlund, Havice, Hertzberg,
Honda, Jackson, Keeley, Knox, Kuehl, Leach, Lempert,
Longville, Lowenthal, Machado, Maddox, Maldonado,
Mazzoni, Migden, Nakano, Robert Pacheco, Papan, Pescetti,
Reyes, Romero, Scott, Shelley, Soto, Steinberg,
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Strickland, Strom-Martin, Thomson, Torlakson, Vincent,
Washington, Wayne, Wesson, Wiggins, Wildman, Wright,
Zettel, Villaraigosa
NOES: Ackerman, Ashburn, Baldwin, Baugh, Briggs, Campbell,
Cox, Frusetta, House, Kaloogian, Leonard, Margett,
McClintock, Olberg, Oller, Rod Pacheco, Runner, Thompson
NOT VOTING: Floyd
CP:jk 9/10/99 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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