BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 299
                                                                  Page  1

          Date of Hearing:   May 24, 2013

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                     AB 299 (Holden) - As Amended:  May 14, 2013 

          Policy Committee:                              Business,  
          Professions and Consumer Protection           Vote: 8-3
                        Health                                       11-6

          Urgency:     No                   State Mandated Local Program:  
          Yes    Reimbursable:              No

           SUMMARY  

          This bill prohibits a health plan or insurer that provides  
          prescription drug benefits from requiring an enrollee to utilize  
          in-network mail order pharmacy services for covered prescription  
          drugs available at an in-network retail pharmacy. Prohibits the  
          plan or insurer from requiring authorization, from either the  
          plan or prescriber, for the enrollee's choice of obtaining a  
          drug through mail order or at a retail pharmacy.  Excludes from  
          this provision drugs unavailable in retail pharmacies due to a  
          manufacturer's instructions or restrictions.
           
           FISCAL EFFECT  

          Significant costs to publicly purchased health coverage  
          programs, including an estimate of $1.5 million to the  
          California Public Employees Retirement System (CalPERS).

           COMMENTS  

        1)Rationale  .  This bill is intended to ensure a patient is able to  
            choose between retail pharmacies and mail order when filling a  
            prescription covered under a health insurance plan. According  
            to the author, all patients are different and what works for  
            one patient may not work for another.  Many patients prefer to  
            receive their prescription drugs from their local pharmacy and  
            others prefer mail order. This bill is sponsored by the  
            California Pharmacists Association and supported by retail  
            pharmacies and numerous consumer organizations. 

        2)Background  .  Health plans and insurers use mail order pharmacies  








                                                                  AB 299
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            as a way to control costs.  Enrollees are given incentives,  
            such as lower prices, for choosing mail order.  For some  
            patients, the trade-off of cheaper medications and home  
            delivery trumps face-to-face contact with a local pharmacist.   
            Other patients prefer the ability to speak with a pharmacist  
            familiar with other drugs the patient is taking so as to guard  
            against dangerous drug interactions.  

            Anthem Blue Cross imposed a policy on enrollees in 2012 to  
            require some drugs for HIV/AIDS and cancer to be purchased  
            through a single mail order pharmacy. After numerous  
            complaints, Anthem rescinded the new requirement.  Health  
            plans and mail order pharmacies oppose this bill.  




        3)Previous legislation  .  SB 1301 (Ed Hernandez), Chapter 455,  
            Statutes of 2012, authorizes a pharmacist to dispense a 90-day  
            supply of a dangerous drug other than a controlled substance  
            pursuant to a valid prescription, except for psychotropic  
            medication or drugs or controlled substances, as specified.  
           
           Analysis Prepared by  :    Debra Roth / APPR. / (916) 319-2081