BILL ANALYSIS                                                                                                                                                                                                    �





                                                                  AB 2418

                                                                  Page  1


          GOVERNOR'S VETO
          AB 2418 (Bonilla and Skinner)
          As Amended August 19, 2014
          2/3 vote

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          |ASSEMBLY:  |75-1 |(May 29, 2014)  |SENATE: |31-1 |(August 21,    |
          |           |     |                |        |     |2014)          |
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          |ASSEMBLY:  |79-0 |(August 25,     |        |     |               |
          |           |     |2014)           |        |     |               |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Requires 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, effective January 1, 2016.

           The Senate amendments  remove a provision of this bill that would  
          have required health plans and insurers to allow enrollees to  
          opt out of mandatory mail order prescriptions programs. 

           AS PASSED BY THE ASSEMBLY  , this bill was largely the same, but  
          also included a provision that required health plans and  
          insurers to allow enrollees to opt out of mandatory mail order  
          prescription program. 

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, one-time costs of $80,000 and ongoing costs of  
          $70,000 per year for review of insurance plan filings and  
          enforcement by the California Department of Insurance.  One-time  
          costs of $275,000 and ongoing costs of $40,000 for development  
          of regulations and enforcement by the Department of Managed  
          Health Care.  Increased health care costs to the California  
          Public Employees' Retirement System of about $6,000 per year due  
          to increased prescription drug benefit costs (various funds).   










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          Increased health care costs to the Medi-Cal program, due to  
          increased prescription drug costs to Medi-Cal managed care plans  
          of about $155,000 per year (General Fund and federal funds). 

           COMMENTS  :  According to the author, this bill is aimed at  
          improving patient medication adherence and health outcomes  
          through streamlining the medication refill process.

          California Pharmacists Association and California Healthcare  
          Institute, co-sponsors of this bill, argue that pharmacists play  
          a key role in helping improve medication adherence and contend  
          that hundreds of clinical studies show improvement in medication  
          adherence and benefits to patient health outcomes when  
          pharmacists work with other members of the care team on  
          medication therapy.

          Health plans, insurers, and pharmacy benefit managers, in  
          opposing this bill, express concern about the costs and  
          administrative complexity of the proposed changes.  Health plans  
          and insurers view this bill as micromanaging the prescription  
          refill process.  
           



          GOVERNOR'S VETO MESSAGE  :

               The bill would require health plans and insurers to  
               apply a prorated daily cost-sharing rate to the  
               refills of certain medications if the prescriber or  
               pharmacist indicates it is in the best interest of the  
               patient and it is for the purpose of synchronizing  
               refill dates for the patient's medications.  The bill  
               also allows for early refills of covered eye products.  


               While I understand the importance of encouraging  
               people to take their prescribed medications, the bill  
               lacks explicit patient consent before changes are made  
               to refills; nor does the bill speak to the supportive  
               elements that have made synchronization programs  










                                                                  AB 2418

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               anecdotally successful. 

               Medication adherence is complicated.  Solutions to  
               this problem will likely require a more holistic  
               approach and collaboration between doctors, patients,  
               pharmacists and health plans.

                
          Analysis Prepared by  :    Dharia McGrew / HEALTH / (916) 319-2097  



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