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131st MAINE LEGISLATURE
SECOND REGULAR SESSION-2024
Legislative Document
No. 2175
S.P. 926
In Senate, January 22, 2024
An Act to Improve Access to Affordable Prescription Drugs in
Underserved Areas
(EMERGENCY)
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule
203.
Reference to the Committee on Health Coverage, Insurance and Financial Services
suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by President JACKSON of Aroostook.
Cosponsored by Speaker TALBOT ROSS of Portland and
Senators: BAILEY of York, CURRY of Waldo, HICKMAN of Kennebec, NANGLE of
Cumberland, RENY of Lincoln, TIPPING of Penobscot, Representatives: ARFORD of
Brunswick, PERRY of Calais.
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1 Emergency preamble. Whereas, acts and resolves of the Legislature do not
2 become effective until 90 days after adjournment unless enacted as emergencies; and
3 Whereas, the federal drug pricing program under Section 340B of the federal Public
4 Health Service Act, 42 United States Code, Section 256b requires prescription drug
5 manufacturers to offer discounted pricing to certain covered entities, including federally
6 qualified health centers; and
7 Whereas, federally qualified health centers serve rural and other underserved areas,
8 delivering health care that would otherwise be inaccessible to residents of such areas; and
9 Whereas, a crucial part of such care is the provision of life-saving prescription drugs
10 at affordable prices made possible by the 340B program, which also generates savings that
11 federally qualified health centers must, as a matter of mission and federal law, use to reduce
12 costs and improve access to services for patients of those health centers; and
13 Whereas, prescription drug manufacturers have recently imposed conflicting and
14 burdensome requirements for covered entities to obtain discounted pricing under the 340B
15 program, depriving patients of access to affordable prescription drugs under the 340B
16 program; and
17 Whereas, the number of retail pharmacies and the hours of operation of retail
18 pharmacies in underserved areas of the State have been dramatically reduced in recent years
19 due to workforce challenges and other economic challenges; and
20 Whereas, federally qualified health centers can compensate for the decline in
21 availability of retail pharmacies and for the restrictive practices of prescription drug
22 manufacturers only by developing or expanding their capacity to provide retail pharmacy
23 services as part of their health center services, yet existing health center revenues and
24 resources are insufficient to support such development and expansion; and
25 Whereas, it is therefore essential to provide immediate funding support for federally
26 qualified health centers to develop and expand retail pharmacy capacity in this State to
27 address the critical shortage of access to affordable prescription drugs; and
28 Whereas, in the judgment of the Legislature, these facts create an emergency within
29 the meaning of the Constitution of Maine and require the following legislation as
30 immediately necessary for the preservation of the public peace, health and safety; now,
31 therefore,
32 Be it enacted by the People of the State of Maine as follows:
33 Sec. 1. 22 MRSA §259, sub-§1, ¶B, as amended by PL 2015, c. 267, Pt. JJJ, §1,
34 is further amended to read:
35 B. Six hundred ninety-nine thousand, one hundred fifty dollars in fiscal year 2001-02
36 to federally qualified health centers to support the infrastructure of these programs in
37 providing primary care services to underserved populations. Forty-four thousand, two
38 hundred fifty dollars must be provided to each federally qualified health center with an
39 additional $8,850 for the 2nd and each additional site operated by a federally qualified
40 health center. For the purposes of this paragraph, "site" means a site or sites operated
41 by the federally qualified health center within its scope of service that meet all health
42 center requirements, including providing primary care services, regardless of patients'
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43 ability to pay, 5 days a week with extended hours. If there is not sufficient funding to
44 meet the formula in this paragraph, the $699,150 must be allocated in proportion to the
45 formula outlined in this paragraph; and
4 Sec. 2. 22 MRSA §259, sub-§1, ¶C, as enacted by PL 2015, c. 267, Pt. JJJ, §1, is
5 amended to read:
6 C. Five hundred thousand dollars, beginning with fiscal year 2015-16 and continuing
7 each fiscal year thereafter, to support access to primary medical, behavioral health and
8 dental services to residents of the State in rural and underserved communities and to
9 assist with provider recruitment and retention. Twenty-five thousand dollars must be
10 provided to each federally qualified health center.; and
11 Sec. 3. 22 MRSA §259, sub-§1, ¶D is enacted to read:
12 D. Seven million five hundred thousand dollars in fiscal year 2024-25 to support access
13 to pharmacy services and affordably priced prescription drugs to residents of the State
14 in rural and underserved communities by providing funds to support federally qualified
15 health centers in developing or improving pharmacy services, including without
16 limitation:
17 (1) Planning, designing, constructing and operating one or more licensed retail
18 pharmacies as part of a federally qualified health center's services;
19 (2) Entering into arrangements, including with one or more federally qualified
20 health centers, to expand the availability of prescription drugs purchased and
21 delivered to patients under the federal drug pricing program under Section 340B
22 of the federal Public Health Service Act, 42 United States Code, Section 256b; and
23 (3) Expanding access to prescription drugs supplied by one or more federally
24 qualified health centers, including without limitation by increasing the number of
25 locations from which patients may obtain prescription drugs, improving existing
26 pharmacy facilities, expanding the availability of automated pharmacy systems as
27 defined in Title 32, section 13702-A, subsection 1 or addressing workforce issues
28 related to pharmacy program planning and operation.
29 Sec. 4. 22 MRSA §259, sub-§3 is enacted to read:
30 3. Allocation of pharmacy services support funding. Each federally qualified health
31 center may apply for funds made available pursuant to subsection 1, paragraph D by
32 providing the Office of Affordable Health Care, as established in Title 5, section 3122, with
33 a budget and plan for developing or improving pharmacy services and access to affordably
34 priced prescription drugs for its patients. The Office of Affordable Health Care shall
35 allocate available funds equitably among all applicants based on the cost-effectiveness and
36 feasibility of the proposed development or improvement of patient access to affordably
37 priced prescription drugs. In developing criteria for awarding available funds, the Office
38 of Affordable Health Care shall consult with and consider the recommendations of a
39 statewide association of federally qualified health centers. Any available funds not awarded
40 in fiscal year 2024-25 must be deposited in a nonlapsing account from which awards may
41 be made in subsequent fiscal periods for the purposes set forth in subsection 1, paragraph
42 D.
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1 Sec. 5. Implementation. The Office of Affordable Health Care, as established in
2 the Maine Revised Statutes, Title 5, section 3122, shall publish a schedule and instructions
3 for the content of applications and criteria for determining awards for the pharmacy
4 services support program described in this legislation. The Office of Affordable Health
5 Care's schedule must ensure that initial awards of funding be made no later than December
6 15, 2024 and must ensure that applicants have no less than 60 days to prepare and submit
7 applications after instructions for the content of applications and criteria for selection have
8 been published. Notwithstanding any provision of law to the contrary, the Office of
9 Affordable Health Care shall ensure that a majority of the persons selected to evaluate the
10 applications have substantial training or experience in the operation and management of a
11 federally qualified health center, by including among those evaluating the applications
12 volunteers recommended by a statewide association of federally qualified health centers.
13 Sec. 6. Change in scope adjustment. Upon issuance of each award pursuant to
14 the Maine Revised Statutes, Title 22, section 259, subsection 3, the Office of Affordable
15 Health Care, as established in Title 5, section 3122, shall promptly implement a change in
16 scope adjustment pursuant to Title 22, section 3174-V, subsection 4 to reflect the ongoing
17 costs for the federally qualified health center receiving the grant to reflect the ongoing costs
18 of operating expanded or improved pharmacy services.
19 Sec. 7. Appropriations and allocations. The following appropriations and
20 allocations are made.
21 OFFICE OF AFFORDABLE HEALTH CARE
22 Office of Affordable Health Care Z320
23 Initiative: Provides one-time funding for the Office of Affordable Health Care to support
24 federally qualified health centers in developing and expanding pharmacy services and
25 access to affordably priced prescription drugs for the patients of such health centers.
GENERAL FUND
All Other
GENERAL FUND TOTAL
26 Emergency clause. In view of the emergency cited in the preamble, this legislation
27 takes effect when approved.
32 SUMMARY
33 This bill directs the Office of Affordable Health Care to provide support for federally
34 qualified health centers to develop or expand the centers' capacity to provide access to
35 affordably priced prescription drugs to patients by increasing the centers' ability to deliver
36 pharmacy services to those patients. The bill appropriates $7,500,000 in fiscal year 2024-
37 25 for that purpose. The bill provides that initial awards of support must be made by
38 December 15, 2024 and that the selection process must be performed by an evaluation
39 team, the majority of whose members must be persons experienced in the operation and
40 management of federally qualified health centers.
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