Governor's Bill No. 5054 proposes the creation of the Prescription Drug Affordability Board within the Office of Health Strategy to advise on prescription drug affordability. The board will consist of five members with relevant expertise, including consumer advocacy and health equity experience, appointed by the Governor with the General Assembly's consent. The board will meet at least quarterly and report annually on drug price trends, cost reduction strategies, and recommendations for cost affordability tools. The bill sets thresholds for scrutinizing drug prices based on wholesale acquisition costs and percentage increases over time, and it outlines a review process for drugs that may pose affordability challenges, including the consideration of various factors and the recommendation of cost containment strategies if necessary.

Additionally, the bill establishes the Cost Growth Benchmark Oversight Commission to advise on health care cost growth and quality benchmarks, excluding representatives from organizations that directly contribute to health care costs. The commission will guide and make policy recommendations, while the executive director will establish procedures for health care entities to address cost growth, including the filing and implementation of performance improvement plans. Civil penalties may be imposed for non-compliance, and the executive director may conduct cost and market impact reviews. The bill also revises the process for annual public hearings on health care expenditures and mandates the participation of significant contributors to health care cost growth. Lastly, the bill introduces an affordability standard for health insurance policies, requiring carriers to demonstrate compliance and allowing the Insurance Commissioner to consider this compliance when evaluating rate increases. The bill includes various effective dates and implements the Governor's budget recommendations with insertions of new sections and amendments to existing sections, with no deletions indicated.

Statutes affected:
Governor's Bill: