BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 2050


                                                                    Page  1





          Date of Hearing:  May 4, 2016


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                               Lorena Gonzalez, Chair


          AB  
          2050 (Steinorth) - As Amended March 18, 2016


           ----------------------------------------------------------------- 
          |Policy       |Health                         |Vote:|18 - 0       |
          |Committee:   |                               |     |             |
          |             |                               |     |             |
          |             |                               |     |             |
           ----------------------------------------------------------------- 


          Urgency:  No  State Mandated Local Program:  YesReimbursable:   
          No


          SUMMARY:


          This bill requires health plans and insurers to implement a  
          procedure for aligning the refill dates of an enrollee's  
          prescription drugs so that prescriptions that are refilled at  
          the same frequency may be refilled concurrently.


          FISCAL EFFECT:


          1)According to the California Health Benefits Review Program  
            (CHBRP), minimal impact to premiums in state-funded programs  








                                                                    AB 2050


                                                                    Page  2





            and the privately funded market.  CHBRP analyzed a similar  
            mandate as included in AB 2418 (Bonilla) of 2014.


          2)Costs to monitor compliance are expected to be minor and  
            absorbable for the Department of Managed Health Care (Managed  
            Care Fund), and $35,000 over the first two years and $5,000  
            ongoing to the California Department of Insurance (Insurance  
            Fund). 


          COMMENTS:


          1)Purpose.  This bill is intended to encourage medication  
            adherence and increase convenience to patients who may have  
            multiple medications with different refill dates.   


          2)Background.  Adherence to a medication regimen is generally  
            defined as the extent to which patients take medications as  
            prescribed by their health care providers. Prescription drugs  
            are important for controlling chronic conditions, but many  
            patients do not take medications as prescribed.  There is  
            some, albeit minor, evidence that medication synchronization  
            can improve adherence to medication regimens.  Beginning in  
            2014, Medicare Part D (prescription durg) plans were required  
            to cover "short refills" in order to make it easier to have  
            prescription medications synchronized, or refilled all at the  
            same time.  


          3)Support. This bill is sponsored by the California Pharmacists  
            Association and has no opposition.  The National Association  
            of Chain Drugs Stores seek an amendment to clarify pharmacies  
            will still receive a dispensing fee when short filled  
            medications are used.  










                                                                    AB 2050


                                                                    Page  3





          4)Prior Legislation. AB 2418 (Bonilla) of 2014 required health  
            plan contracts and health insurance policies to allow for the  
            synchronization of prescription refills and permit refill of  
            topical ophthalmic medications at 70% of the predicted days of  
            use.  It also required plans and insurers to apply a prorated  
            daily cost-sharing rate to the refills of prescriptions that  
            are dispensed by a participating pharmacy for purposes of  
            synchronization.  AB 2418 was vetoed by Governor Brown, who  
            stated the bill lacked explicit patient consent before changes  
            are made to refills and it did not address supportive elements  
            that have made synchronization programs anecdotally  
            successful.  AB 2050 does not appear to address the veto  
            message, but does offer more flexibility to plans to design  
            synchronization procedures than AB 2418. 


          Analysis Prepared by:Lisa Murawski / APPR. / (916)  
          319-2081