General Assembly Passes Budget: Transparency and MTM for State Employee Health Plan

Late in the afternoon on Wednesday the Virginia General Assembly passed the 2013-14 budget.  Included in the budget are numerous items that impact the profession of pharmacy.  They include:  

• Transparency requirement for future contract administration of the State Employee health insurance program
• The language requires that future contracts for the State Employee health insurance program include provisions which ensure the Department of Human Resource Management has complete access to all financial information regarding the contractors administration of the health insurance program

• Prohibits the establishment of a retail maintenance network for maintenance drugs for the State Employee health insurance program

• Creation of a Medication Therapy Management pilot program for the State Employee health insurance program.
• The Department of Human Resource Management shall develop a proposal to implement a Medication Therapy Management pilot program for state employees with certain disease states including Type II diabetes 

VPhA worked with budget conferees in providing information for the Transparency language for the State Employee health insurance program.  In addition, EPIC Pharmacies, VACDS and VPhA worked very closely with the General Assembly on the inclusion of the MTM pilot program.  

Governor McDonnell will now have until early May to review the budget and offer any amendments and/or vetos.  While these items are HUGE wins for patient access to pharmacy services, changes to any of these items could be a possibility.  We will let you know if the Governor decides to make any changes to the budget that would have an impact on the above.  Even with possible Governor amendments, the General Assembly can still overrule the Governor, which they will be returning to Richmond on May 14th to address.  Please watch your email, fax machine and phone lines for updates on the budget process.