Maine Prescription Drug Discount Program To Take Effect Saturday

Maine Rx Plus, a program that will provide discounts on prescription drugs to as many as 275,000 state residents, will begin Saturday, state officials announced Tuesday, the Portland Press Herald reports. Under the program, state residents who do not have prescription drug coverage and have annual incomes of less than 350% of the federal poverty level -- about $31,440 for an individual and $42,420 for a couple -- can receive discounts of 10% to 25% for brand-name prescription drugs and of as much as 60% for generic medications (Huang, Portland Press Herald, 1/14). State officials made the announcement after they delayed implementation of Maine Rx Plus last week to consider the effect that the new Medicare law (HR 1) would have on the program. State officials had planned to implement the program on Jan. 1 (Kaiser Daily Health Policy Report, 1/6). Gov. John Baldacci (D) on Tuesday said that the state will coordinate Maine Rx Plus with the Medicare law. In addition, the state will combine a current program called Drugs for the Elderly with Maine Rx Plus, Baldacci said (Adams, AP/Long Island Newsday, 1/13). Maine Rx Plus -- enacted in June 2003 -- is modeled after Maine Rx, which was enacted in 2000 but never implemented because of a legal challenge raised by the Pharmaceutical Research and Manufacturers of America. Under Maine Rx, the state would have negotiated with pharmaceutical companies for rebates and passed the rebates through pharmacies to state residents without prescription drug coverage, regardless of income. In May 2003, the Supreme Court ruled 6-3 to lift an injunction on Maine Rx but raised several questions about the structure of the program, such as the lack of income eligibility limits. In response, Baldacci dropped plans to launch Maine Rx and submitted a proposal to the state Legislature for Maine Rx Plus (Kaiser Daily Health Policy Report, 1/6). Baldacci said that the state has sent Maine Rx Plus membership cards to thousands of eligible state residents.

Access to Discounts
About 110 pharmacies in Maine have agreed to participate in Maine Rx Plus. However, about 100 other pharmacies -- such as those operated by pharmacy chains Rite Aid, CVS and Community Pharmacies -- have decided not to participate because of concerns that they cannot afford to offer discounts to a larger number of state residents. "It's unclear" whether the state will implement the second phase of Maine Rx Plus, in which the state would place products from pharmaceutical drug companies that refuse to provide discounts on "prior authorization" lists; health care providers would have to receive state approval to prescribe products on the lists to Medicaid beneficiaries, according to the Press Herald (Portland Press Herald, 1/14).

Baldacci Names Dirigo Health Executive Director
In other Maine news, Baldacci on Friday named Cape Elizabeth businessperson Thomas Dunn, formerly with the Accenture management consulting firm, as the first executive director of Dirigo Health, the state universal health insurance program scheduled to take effect in July, the AP/Portland Press Herald reports (Quinn, AP/Portland Press Herald, 1/10). Dirigo Health, a public-private health insurance program enacted in June 2003, will offer lower-cost health plans to self-employed individuals and to employees of small businesses. Under the program, Maine will contract with private health insurers and compete with current health plans to offer coverage to employees who work at least 20 hours per week. Employers will cover as much as 60% of the cost of the premiums, and employees will pay the remainder of the cost. The state will provide premium subsidies on a sliding scale to program participants with annual incomes of less than 300% of the federal poverty level. The Governor's Office of Health Policy and Finance estimates that the program will cost less than $300 per month for individuals (Kaiser Daily Health Policy Report, 6/19/03). Dunne has worked with the health policy and finance office for several months and will collect an annual salary of one dollar as Dirigo Health executive director, according to Baldacci health policy aide Trish Riley. Baldacci and Robert McAfee, chair of the Dirigo Health board of directors, also named Karynlee Harrington, former Cigna vice president of sales and customer support for Maine and New Hampshire, as director of sales and marketing for the program (Quinn, AP/Portland Press Herald, 1/10).