NOTE: As provided in LFC policy, this report is intended for use by the standing finance committees of the
legislature. The Legislative Finance Committee does not assume responsibility for the accuracy of the information
in this report when used in any other situation.
Only the most recent FIR version, excluding attachments, is available on the Intranet. Previously issued FIRs and
attachments may be obtained from the LFC office in Suite 101 of the State Capitol Building North.
F I S C A L I M P A C T R E P O R T
SPONSOR: |
Wilson |
DATE TYPED: |
02/01/01 |
HB |
|
SHORT TITLE: |
Fill Prescriptions at Federal Health Centers |
SB |
SJM 9 |
|
ANALYST: |
Wilson |
APPROPRIATION
Appropriation Contained
|
Estimated Additional Impact
|
Recurring
or Non-Rec |
Fund
Affected |
FY01 |
FY02 |
FY01 |
FY02 |
|
|
Indeterminate |
|
|
(Parenthesis ( ) Indicate Expenditure Decreases)
SOURCES OF INFORMATION
Health Policy Commission
Agency on Aging
SUMMARY
Synopsis of Bill
HJM 9 calls for a joint effort between the state Primary Health Care Association, the University
of New Mexico Hospital, the State Hospital Association and other interested parties to examine
opportunities that allow Federally Qualified Health Clinics (FQHCs) to fill prescriptions for their
patients who receive treatment at specialty institutions.
Significant Issues
Under the present system, either the UNM hospital incurs the costs for providing medications to
these patients or patients who can not afford to pay full price for prescriptions do not receive
needed medication. Both outcomes are undesirable. It is possible the solution to this problem
will involve either a change in federal regulation or a waiver or by regulatory requirements of the
State Board of Pharmacy. Representatives from the federal Health Care Financing Authority
(HCFA) and the Board of Pharmacy need to be included in the study group.
RELATIONSHIP
Relates to:
SB 140, Indian Prescription Drug Purchase
SB 141, Prescription Drug Fair Pricing Act
SB 142, NM Prescription Drug Discount Act
SB 143, Prescription Drug Senior Program
SB 144, Prescription Drug Bulk Purchasing
HJM 21, Affordable Drug Program Options for Seniors
HJM 22, Study Rising Costs of Prescription Drugs
HB 297, NM Prescription Drug Discount Act
HB 298, Native American Prescription Drug Program
HB 300, Special Prescription Drug Program for Seniors
HB 301, Prescription Drug Fair Pricing Act
HB 302, Prescription Drug Benefit for Seniors
SUBSTANTIVE ISSUES
- Uninsured people pay the highest cost for drugs. Studies have shown that people are less
likely to buy necessary prescription drugs if their priorities are to buy food, and take care of
their household and family. Seniors, the disabled, and others may have a difficult time
traveling great distance for health care, and will do without. Community Health Centers were
established to fulfill a need for people that otherwise would have no health care access.
- Hospitals, HMOs, insurance companies, government agencies and mail order companies are
able to pay significantly lower prices than the drug stores from which millions of Americans
buy their medications. Different government agencies (Medicaid, Medicare, Veterans
Administration, Department of Defense) are charged widely different prices for the same
drug.
- Retail prices vary for medication depending on source. Without insurance, the average cost
of Methotrexate, to treat Rheumatoid Arthritis, Psoriasis, and Inflammatory Bowel Disease
can cost $47.84; Coumadin, to treat cardiac conditions, can cost $20.91. (Sanders)
- The National Association of Community Health Centers, Inc. reports that Community Health
Clinics provide access to health care for thousands of people who have been locked out of the
"traditional" health care system.
- Health center services are not free, and charge on a sliding fee scale according to income.
- FQHCs are located in medically underserved areas and are eligible to receive cost based
reimbursement rates for Medicaid and Medicare.
- FQHCs in New Mexico are located in rural areas. People travel from surrounding, often
isolated, areas to receive treatment at the clinics. Traveling an additional 60-500 miles to get
specialty care or prescription medication creates a bigger hardship for people who may be ill,
have no private transportation of their own, or are disabled.
- University of New Mexico Hospital treats low income, uninsured people who live within and
outside Bernalillo County.
- The Primary Care Association is a strong advocate for community health clinics, and
understands the economic, social, cultural and other issues that the clinics face.
- The New Mexico Hospital Association is a strong advocate for hospitals, and understands
that similar issues face many rural hospitals.
- The collaborative committee will need to establish a methodology on how this Joint Memorial
will be done.
DW/ar