February 25, 2019

In This Issue
MMA Pursues Prior Authorization Reform in 129th Maine Legislature
HHS Releases Proposed Rule on Drug Rebates
Legislation to Address Gun Violence Advances in the House
Maine Seeks Federal Waiver to Assist Opioid Response
Medical Care a Bit Rough in 1860s Maine
HHS Final Rule Seeks to Curb Title X Funding
MMA Wants Your Feedback: Physician Wellness Survey
MMA Legislative Call Tuesday, February 26th
State House Highlights of the Week: A Packed House in HHS for Hearings on Banning Liquid Nicotine, Requiring Vitamin K Injections
Upcoming Specialty Society Meetings
MaineGeneral Offering X Waiver Training March 9th in Waterville
Identifying Substance Use Early Saves Lives! - SBIRT with Motivational Interviewing Training - 1-day Sessions Offered on March 2 and April 6
Maine Society of Orthopaedic Surgeons Annual Meeting March 23, 2019
NAMI Maine’s Beyond the Basics in Suicide Prevention Conference - Friday, April 12, 2019
Board Certified Family Physician
Internal Medicine Outpatient Physician
BC/BE Family Medicine Physician
Part-time Physician for Academic Year Contract Position
Psychiatric Mental Health NP - Leeds
PCHC in need of Pediatrician at Multiple Locations!
Outpatient Internal Medicine Physician – Bangor, Maine
Outpatient Family Medicine - Brunswick, Maine
Opportunities at the VA for Volunteer Physicians
Volunteer Opportunity with Partners for World Health

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HHS Releases Proposed Rule on Drug Rebates

On Jan. 31, HHS released its long-awaited proposed rule on prescription drug rebates. The proposal would make sweeping changes to the way drugs are priced and contracted for by manufacturers, pharmacy benefit managers (PBM) and health plans. In the proposed rule HHS calls for changes to the anti-kickback statute safe harbors for discounts and rebates given by pharmaceutical manufacturers to health plans and PBMs. The changes would eliminate the safe harbor protections for such discount arrangements, while creating a new safe harbor for discounts provided to beneficiaries at the point of sale. If finalized rebates would be passed on to patients directly, instead of to the health plan or PBM. The proposal also calls for increased transparency around flat fee arrangements between pharmaceutical manufacturers and PBMs.

The AMA agrees that patients should see the benefit of discounts, rebates and other price concessions on prescription drugs and is very supportive of the administration's calls for increased transparency of arrangements between pharmaceutical manufacturers and PBMs/health plans. However, there are many outstanding questions about the ultimate impact of the administration's proposal, and the AMA is carefully considering the potential effect on items such as Part D plan premiums, drug list prices and the availability and size of future discounts and rebates.

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