State Legislative Issues
2016 Legislative Session
APA Bill to Exempt Prescription Sales from Business License Fees Introduced
On the first day of the 2016 regular session APA worked with Representative Ron Johnson to have HB58 introduced which mandates that prescription drugs be exempt from the calculation of business license fees based on gross receipts. Some of you may have been contacted by APA recently as we gathered information on the calculation of business license fees across the state. There is a wide variance on what pharmacies are charged for business licenses ranging from $100 to tens of thousands – all depending on how their municipality decides to set it up. APA believes strongly that a pharmacy’s prescriptions sales should not be classified the same as tire sales, clothing, or liquor (bar) sales and yet, that is exactly what is happening in many areas of the state. The dispensing of prescription medications constitutes a professional service and should be viewed in the same manner as other professional services such as those of a lawyer, dentist or physician. This impacts independently owned pharmacies, LTC pharmacies, chains, and hospital/clinic outpatient pharmacies. The bill has been referred to the House Ways and Means General Fund Committee. Please contact your representative and ask that they support HB58.
HB58 Talking Points
2015 Legislative Session
2015 Special Session Updates:
Thursday, September 17, 2015:
APA has been working with the Alabama Department of Revenue and the Alabama Medicaid Agency on the implementation of the supplemental pharmacy tax that was signed into today. We will forward by email to members, a notice from the Revenue Department regarding the filing requirements for the tax increase. We are pleased to be able to provide you with this information and will continue to keep you updated as we learn more on the increase in the Medicaid dispensing fee that is tied to this tax. It is our request to Medicaid that the increased fee be implemented upon their submission of the plan approval from CMS and not wait until the plan has received final approval, which could take several months. The law requires Medicaid to file the plan change requesting approval no later than sixty days following the law becoming effective. We fully anticipate that Medicaid will do the right thing and implement the increased dispensing fee of $13.90 at that time but we will continue to impress upon them the importance of this action.
Please log-in to your APA member account to access the following links:
HB8 as signed by Governor Bentley (PDF)
Alabama Department of Revenue: Pharmaceutical Providers Tax Brochure (PDF)
Notice from AL Department of Revenue - Released September 17, 2017 (PDF)
Wednesday, September 9, 2015:
On September 8th, the Alabama Legislature began their second special session with the sole purpose of passing a State Budget. With the new fiscal year beginning October 1st, a budget must be passed to avoid a government shutdown. APA has been working with legislators and state leaders for months now on possible solutions to the general fund deficit. We were approached in the last days of the regular session this Spring to consider an increase in the pharmacy tax. Because federal matching funds are available on this tax, Medicaid agreed to pursue an increase to bring the dispensing fee from $10.64 to $13.90 if we allowed an increase in the tax from 10 cents to 25 cents. Our research showed this change would positively impact approximately 85% of the pharmacies in this state. The ones who would be negatively impacted are those that fill a low volume of Medicaid prescriptions. The session ended with no budget being approved.
The issue was raised again last month in the first special session but again ended with no budget passed. Last night, HB8 was introduced that would create a supplemental pharmacy tax on all prescriptions filled for Alabama citizens. We were successful in the inclusion of language in this bill that would sunset the tax increase in 2017. Also included is a requirement that Medicaid obtain an increase in the dispensing fee effective October 1, 2015 and ties this increase to the tax. Therefore, if the dispensing fee increase is not approved or is revoked, the supplemental tax would be removed as well.
While we understand a pharmacy tax increase is not optimal for all pharmacies, this agreement was a better option than others presented. Medicaid has worked with the pharmacy provider groups to avoid the implementation of a PBM and we will continue to fight this action. We have been clear with the leadership that they cannot continue to balance the Medicaid budget on the backs of the providers in this state. We have agreed to work with them on this legislation as long as all stipulations stay in place and as long as other health care provider groups such as nursing homes and hospitals also partner on cuts. APA is your voice at the table on this issue and we will continue to do our best to represent your interests legislatively. Please contact your legislator and stress the importance of appropriately funding healthcare in this state, even if that means the consideration of other sources of revenue.
Download a copy of HB8
August 11, 2015
The Alabama Legislative 1st Special Session of 2015 ended with no General Fund Budget. A Senate Committee passed out a substitute for HB 1, General Fund Budget that restored the budget to the same levels of the Budget that was sent to Governor Bentley during the Regular, which he vetoed. The budget that was sent to the Senate by the House during the Special Session had a $156m cut to Medicaid. The Senate substitute only had a $34m cut to Medicaid. On August 10, the substitution to HB 1 passed the Senate by only a 19-15 vote but the House defeated the sub by a vote of 92-2 thus ending the session.
Thursday, August 6, 2015:
Late on Wed, August 5th, it was reported that the Medicaid cut of $156M passed the House. Curious as to how your AL State Representative voted on the General Fund Budget which included a $156M Budget Cut to Medicaid? Look up their vote HERE.
Wednesday, August 5, 2015:
Late yesterday afternoon, the House General Fund Committee passed a General Fund Budget out of committee and sent it the floor of the House. This budget level funded all of the State General Fund agencies except Medicaid which it CUT $156M to balance the budget. It could come up for a final vote today. Suffice it to say, the Governor will likely veto any such budget in the unlikely event it passes the House and Senate. This battle is far from over and the rumor mill is as strong as ever. As we’ve told you before we are monitoring all of the activity at the State House and there seems to be a underlying movement to push the Medicaid resolution into a second special session but this can’t be stated for sure until later in the week. We’ll continue to keep you posted as the special session progresses.
Tuesday, August 4, 2015:
APA leadership represented pharmacy today in a meeting with Dr. Williamson, Chairman of the Alabama Medicaid Transition Task Force, and members of the House and Senate. The focus of the meeting was to discuss potential revenue measures for the budget crisis. One thing discussed was an increase in the pharmacy provider tax that would be tied to an increased dispensing fee. At this time, we are not sure if any measures discussed during this meeting will be introduced during the special session but want to keep you informed.
On a related note, Representative Wadsworth introduced House Bill 22 (HB22) yesterday proposing to increase the pharmacy provider tax from 10 cents to 31 cents. APA is opposed to this legislation and is working to ensure it doesn’t pass.
APA continues to be your voice at the table in these very important discussions. Be assured that we are advocating for you and the protection of your profession so that your focus can remain on treating your patients.
Since the 2015 Regular Legislative Session began on March 3rd, over 300 bills have been introduced. APA is currently monitoring all legislation and identifying bills that have a potential impact on our members and the profession of pharmacy. Visit this site often to review the 2015 State Legislation Tracking Log and keep up with the legislation that could impact you.
2015 State Legislation Tracking Log - updated May 12, 2015
We are anticipating the introduction of our very own Collaborative Drug Therapy Management Act that would give pharmacists the authority to enter into collaborative practice agreements with physicians to treat patients. The talking points to that bill can be found on this page. The bill number will be added to this document as soon as it introduced.
Collaborative Drug Therapy Management Act:
Sign the Petition on Choice.org!
HB494: CDTM Talking Points Color Brochure (PDF)
CDTM Talking Points Paper (PDF)
How can you help? Get to know your legislators, download this sample letter supporting HB494 and personalize it, and contact them via email or phone to ask they support the CDTM Act and the patients you serve. It’s a busy time for pharmacy and you can be assured that APA is a strong voice for you at the Alabama State House.
Alabama Medicaid Budget Reduction Report:
Medicaid Budget Report (PDF) - released April 8, 2015
On April 8, 2015, Dr. Don Williamson, Chair of the Medicaid Transition Task Force, presented a budget report for Medicaid to the State Legislature. For FY2014, Pharmacy expenditures accounted for 11% of the total Medicaid spend. Dr. Williamson explained the program cuts that would be necessary if the Legislature doesn’t appropriate required funds. Those cuts include implementing a statewide PBM for pharmacy services with mail order or a preferred provider network. It is important to note that other program cuts were provided as options affecting all provider types and patients. While these cuts were not recommended, they may be necessary if funding isn’t allocated.
It is crucial that you contact your state legislator today to ask they fully fund the Alabama Medicaid program. Inform them that a statewide PBM with mail order or a preferred provider network would be crippling to pharmacies across Alabama and would result in the closure of pharmacies and a loss of jobs.
2014 Legislative Session
During the 2014 Alabama state legislative session, 47 bills that had a direct impact on pharmacy were introduced to the Senate or House of Representatives. The following is a detailed synopsis of Bills that passed both the Alabama State House of Representatives and Senate during the 2014 Legislative session and have been passed on to Governor Bentley for signing, as well as legislation that was introduced but not advanced.
Click Here to Download the APA 2014 Report
2013 Legislative Session
SB340 (Reed) -
This bill would provide for the delivery of health care services under the Medicaid program on a managed care basis through the Medicaid Agency or through regional care organizations or alternate care providers that would operate in not more than eight geographic Medicaid regions.
HB237 (Beech) – This bill would allow pharmacies to accept unused and expired medications for destruction.
HB36 (Johnson) and SB76 (Waggoner) – These bills would authorize the Board of Pharmacy to adopt rules to provide for automated dispensing machines in nursing homes.
HB150 (McClendon) and SB115 (Ward) – These bills would amend the laws for the Prescription Drug Monitoring Database (PDMP) including removing the language that states pharmacists shall have no requirement or obligation to access or check the information in the database prior to dispensing or administering medications or as part of their professional practice.
HB2 (Todd) – This bill would authorize the medical use of marijuana only for certain qualifying patients who have been diagnosed by a physician as having a serious medical condition.
HB152 (Weaver) and SB114 (Ward) – These bills would prohibit the practice of deceptively obtaining the same or similar controlled substance from two or more medical practitioners in a concurrent time period.
HB110 (McClendon) – The Medicaid Fraud Reduction Act of 2013.
HB202 (Knight) – This bill would make changes to sales tax exemption on OTC medications.
SB3 (Dial) – The Ensuring Appropriate Access to Medicines for Premature Infants Act - Requires Medicaid to develop and implement policies and procedures to streamline the process for access to covered outpatient drugs for premature infants and to develop standards and common practices applicable to Medicaid programs that ensure timely and appropriate access to care for premature infants.
HB108 (Greer) – This bill would provide that religiously affiliated or motivated employers shall not be required to provide contraceptive or abortifacient drugs, devices, or methods to its employees directly through any insurance policy or in any other way.