ASSEMBLY RESOLUTION No. 94

 

STATE OF NEW JERSEY

 

210th LEGISLATURE

 

INTRODUCED FEBRUARY 21, 2002

 

 

Sponsored by:

Assemblywoman ELBA PEREZ-CINCIARELLI

District 31 (Hudson)

Assemblyman JOSEPH V. DORIA, JR.

District 31 (Hudson)

 

 

 

 

SYNOPSIS

    Urges Commissioner of Human Services to provide fee-for-service prescription drug benefits for SSI recipients under Medicaid.

 

CURRENT VERSION OF TEXT

    As introduced.

 


An Assembly Resolution urging the Commissioner of Human Services to provide prescription drug benefits for Supplemental Security Income recipients under the Medicaid program on a fee-for-service basis.

 

Whereas, The Department of Human Services is in the process of implementing a phased-in, county-by-county transfer, on a mandatory basis, of most recipients of Supplemental Security Income (SSI) under P.L.1973, c.256 (C.44:7-85 et seq.) into managed care plans under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.) that include prescription drug benefits; and

Whereas, This transfer will force participating community pharmacies to incur a 60% reduction in gross income per prescription, which will drive many of these establishments out of business, and follows on the heels of 36 community pharmacy closures in the cities of Newark, Trenton, Perth Amboy, Paterson and Jersey City during the past five years; and

Whereas, These past and projected closures of community pharmacies run counter to the efforts of State government to revitalize our urban areas and support the growth of small businesses; and

Whereas, These community pharmacy closures will also jeopardize the health and well-being of low-income persons, senior citizens and persons with disabilities living in these areas, who will lose access to pharmacists who are knowledgeable about their patients and their individual health conditions, and will have to travel to the suburbs to obtain their prescription medications, thereby incurring an additional expense and inconvenience that they can ill afford in view of their meager incomes and frequent lack of transportation; and

Whereas, Managed care organizations may impede Medicaid beneficiaries' ready access to certain prescription drugs and inconvenience community pharmacists by refusing, in some instances, to cover a drug that has been prescribed by a patient's physician because the managed care organization negotiated a better pricing arrangement with a pharmaceutical manufacturer for an alternative drug; and

Whereas, Many states across the country have begun to realize the shortcomings of managed care for pharmaceutical benefits; and our neighbor, New York State, has carved these benefits out of its Medicaid managed care program while providing safe, effectively managed and accessible prescription drug coverage on a fee-for-service basis; and

Whereas, The transfer of Medicaid prescription drug benefits for SSI recipients from fee-for-service to managed care will compromise the ability of the Legislature to properly exercise its legislative oversight responsibilities over this program through the elimination of the current Medicaid fee-for-service drug manufacturers' rebate program that has helped to assure quality of care and cost-effectiveness in regard to the provision of Medicaid prescription drug benefits; and

Whereas, It is clearly in the interest of both SSI recipients and community pharmacies throughout New Jersey for prescription drug benefits under the Medicaid program to be provided on a fee-for service basis, in accordance with a reimbursement methodology established by the Commissioner of Human Services, and to be carved out of all managed care plans offered in this State to Medicaid recipients; now, therefore,

 

    Be It Resolved by the General Assembly of the State of New Jersey:

 

    1. This House respectfully urges the Commissioner of Human Services to provide prescription drug benefits for Supplemental Security Income recipients under the Medicaid program on a fee-for-service basis, in accordance with a reimbursement methodology established by the commissioner, and to exclude these benefits from all managed care plans offered in this State to Medicaid recipients.

 

    2. Duly authenticated copies of this resolution, signed by the Speaker of the General Assembly and attested by the Clerk of the General Assembly, shall be transmitted to the Commissioner of Human Services and the Governor.

 

 

STATEMENT

 

    This resolution respectfully urges the Commissioner of Human Services to provide prescription drug benefits for Supplemental Security Income (SSI) recipients under the Medicaid program on a fee-for-service basis, in accordance with a reimbursement methodology established by the commissioner, and to exclude these benefits from all managed care plans offered in this State to Medicaid recipients.