2018 Delaware End Of Session Report
State Appropriations: On June 30th, Governor Carney signed a $4.27 billion budget for FY 2019. The budget included pay raises for state workers, increased special education funding, and $46 million in deferred spending for next year’s operating budget. The state ended the year with a small revenue surplus, which has not happened since prior to 2009.
The FY ’19 state budget funds the cancer council recommendations (cancer control) and tobacco control funding at FY ‘18 levels- $8.49 million and $1.187 million respectively. Delaware Health and Social Services (DHSS) has flexibility regarding the allocation of the funds within the cancer and tobacco control programs. A final budget number will be released by DHSS in late July/early August.
Also, the budget restored the DE Prescription Assistance Program which helps low income seniors cover the prescription donut hole in their Medicare Part D coverage. A total allocation of $2 million was given to this program.
Tobacco Control: ACS CAN successfully opposed House Bill (HB) 417, which would have lowered the excise tax rate on premium cigars. HB 417, passed out of the House Revenue and Finance Committee but due to fiscal concerns and pressure from health advocates it was returned to the House Appropriations Committee where it died in late June.
Access to Care: Senate Bill (SB) 176 Senate Substitute 1, created an Opioid Impact Fee, to be paid by manufacturers of opioids, on all opioids dispensed in the state. The fee would have funded state addiction treatment services. The original bill, SB 176, was supported by ACS CAN because it protected patients from manufacturers passing along the fees to patients. SB 176, Substitute 1, removed patient protections and left patients potentially vulnerable to increased costs. ACS CAN, opposed SB 176, Substitute 1, and submitted comments in opposition to the bill sponsor. The bill was LOT in the Senate in late June and never received a vote.
Senate Concurrent Resolution (SCR) 70, which currently awaits the Governor’s signature, requires the formation of a task force to explore the creation of a Medicaid buy in program for Delawareans with incomes over 138% of the Federal Poverty Level. A report to the Governor and General Assembly is due by January 31, 2019.
House Bill (HB) 425, which currently awaits the Governor’s signature, removes the ‘gag clause’ between pharmacists and pharmacy benefits managers. The bill prohibits a contract between a pharmacy benefits manager and a pharmacist from prohibiting the pharmacist to do the following: (1) Providing an insured with information regarding the retail price of a prescription drug or the amount of the cost share for which the insured is responsible for a prescription drug. (2) Discussing with an insured information regarding the retail price of a prescription drug or the amount of the cost share for which the insured is responsible for a prescription drug. (3) If a more affordable, therapeutically equivalent prescription drug is available, selling the more affordable, therapeutically equivalent prescription drug to the insured. ACS CAN supported this bill.
House Bill (HB) 441, which currently awaits the Governor’s signature, requires pharmacy benefit managers to ask prescribers if a prescription requiring prior authorization is for a long term or chronic condition and if so, the pharmacy benefit manager may not ask for reauthorization for the same prescription more frequently than every 12 months. Also, a pharmacy benefits manager may not require prior authorization for coverage of a 72-hour supply of a medication that is a non-controlled substance in an emergency situation. ACS CAN supported this bill.
Senate Bill (SB) 227, which currently awaits Governor’s signature, creates a Primary Care Reform Collaborative to develop annual recommendations that will strengthen the primary care system in Delaware. The scope of the recommendations must include the following: payment reform, value based care, workforce recruitment, increased integrated care (i.e. behavioral health and women’s) and evaluation of system wide changes to primary care, using claims data obtained from the DE Health Care Claims Database. ACS CAN did not take a position on this bill but will continue to monitor the work of the Collaborative.