2014 Session

Budget Amendments - HB30 (Floor Approved)

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Employee Health Insurance - Parity Rx Co-payments

Item 467 #3h

Item 467 #3h

First Year - FY2015 Second Year - FY2016
Central Appropriations
Central Appropriations FY2015 ($240,300) FY2016 ($240,300) GF

Page 397, line 4, strike "$120,942,739" and insert "$120,702,439".
Page 397, line 4, strike "$157,709,181" and insert "$157,468,881".
Page 398, line 24, after "at" strike "$24,584,583" and insert "$24,344,283".
Page 398, line 25, before "the second year" strike "$59,260,533" and insert:
Page 398, line 44, after "6." insert "a."
Page 398, line 46, after "network." insert "Furthermore, when implementing co-payment modifications for the plan effective July 1, 2014, the increase in co-pays for home delivery pharmacy (mail service) shall be increased by an amount that reflects proportional parity, regarding the volume of product the beneficiary is able to receive, compared to retail pharmacy services.        
b. Going forward, the Department shall evaluate the impact of the current co-payment schedule for pharmacy products and develop a plan to establish proportional parity between co-pay amounts for retail pharmacy services and home delivery pharmacy (mail service) to be implemented by July 1, 2015, or upon the effective date of the next contracted health plan for state employees, whichever is sooner.  The Department shall report its plan to the Chairmen of the House Appropriations and Senate Finance Committees and to the Department of Planning and Budget by October 1, 2014."

(This amendment requires the Department of Human Resource Management for fiscal year 2015 to increase the co-payments for mail order pharmacy products in a manner proportional to the increase in co-payments for retail pharmacy services. The introduced budget assumed a $5 increase in co-payments, for Tier 2, 3 and 4 pharmacy products, at retail pharmacies and only $10 for mail order products even though an individual may receive approximately 3 times as much supply through mail order. Furthermore, the language requires the Department to develop a proposal for proportional parity, over the entire co-payment structure, between co-pay amounts for retail pharmacy services and home delivery pharmacy and report to the General Assembly prior to the 2015 session.)