GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1991

S	1 

SENATE BILL 1232

Short Title:  Open Formulary.	(Public)
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Sponsors: Senator Sherron.
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Referred to:  State Personel and State Government.
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June 8, 1992

A BILL TO BE ENTITLED
AN ACT TO REDUCE STATE EXPENDITURES BY PROVIDING THAT UNLESS DRUG MANUFACTURERS AGREE TO REIMBURSE THE TEACHERS' AND STATE EMPLOYEES' COMPREHENSIVE MAJOR MEDICAL PLAN FOR INCREASES IN THE WHOLESALE PRICE OF PRESCRIPTION DRUGS, SUCH DRUGS SHALL NOT BE COVERED UNDER THE PLAN.
The General Assembly of North Carolina enacts:
Section 1.  G.S. 135-40.6(8)a reads as rewritten:
"a.	Prescription Drugs: The Plan's allowable charges for prescription legend drugs to be used outside of a hospital or skilled nursing facility are ninety percent (90%) of the average wholesale price. A dispensing fee for qualified providers shall be determined by the Executive Administrator and Board of Trustees. The Plan will pay allowable charges for each outpatient prescription drug less a copayment to be paid by each covered individual equal to the provider dispensing fee set by the Executive Administrator and Board of Trustees. A prescription legend drug is defined as an article the label of which, under the Federal Food, Drug, and Cosmetic Act, is required to bear the legend: ‘Caution: Federal Law Prohibits Dispensing Without Prescription.' Such articles may not be sold to or purchased by the public without a prescription order. Benefits are provided for insulin even though prescription is not required.  Notwithstanding the provisions of this paragraph, the Plan does not pay for any prescription legend drug during a fiscal year unless the manufacturer of that drug has contracted with the Plan to rebate to the Plan any revenues the manufacturer has received, on account of sales of such drugs to persons enrolled in the Plan, because of increases in the wholesale price of that drug that took effect other than at the beginning of the fiscal year."
Sec. 2.  This act becomes effective July 1, 1992.