Substitute Bill No. 11 aims to improve prescription drug access and affordability in the state, with provisions set to take effect on July 1, 2025. The bill introduces definitions for key pharmaceutical terms and establishes a pricing framework for identified prescription drugs, which cannot exceed a reference price adjusted by the consumer price index, starting January 1, 2026. It includes civil penalties for manufacturers and distributors that violate these pricing regulations, calculated based on the revenue difference from the reference price. The Commissioner of Revenue Services will enforce these provisions, including the collection of penalties and compliance checks. Additionally, the bill allows manufacturers and distributors to contest penalties through a hearing process and outlines an appeals process to the superior court for dissatisfied parties.

The legislation also addresses Medicaid reimbursement for nursing homes, emphasizing quality metrics and financial accountability, and mandates that nursing homes allocate a minimum of 80% of their funding to direct resident care by July 1, 2025. It expands emergency Medicaid coverage, revises health insurance policies regarding diabetes treatment, and establishes a Canadian prescription drug importation program to reduce costs. The bill creates a task force to study drug shortages and mandates the establishment of a Vaccines and Related Biological Products Advisory Committee to enhance state preparedness. Overall, Substitute Bill No. 11 seeks to enhance healthcare access, affordability, and accountability across various sectors while ensuring compliance with new regulations.

Statutes affected:
Committee Bill:
HS Joint Favorable Substitute:
File No. 420:
JUD Joint Favorable:
APP Joint Favorable: