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By Rose Hoban
This year, the big health care story at the General Assembly was the decision to overhaul North Carolina’s Medicaid program, and that heavy legislative lift was enough to sideline many lighter health care bills.
But a number of bills did find their way onto the floors of the House and Senate in the waning days of the 2015 legislative session, where they garnered enough votes to head to the desk of Gov. Pat McCrory.
Here are some:
Regulating pharmacy benefits managers
A rapidly growing segment of the health care industry is pharmacy benefits managers, companies that administer prescription drug benefits as part of an insurance plan. Pharmacy benefits managers process prescriptions for groups paying for the pharmaceuticals, usually insurance companies or corporations.
Increasingly, insurance plans are pushing their beneficiaries to use PBMs, often mail-order services, which use their size to negotiate with drugmakers and pharmacies.
But it’s hard for state regulators like N.C. Insurance Commissioner Wayne Goodwin to go after them if they engage in price gouging or overcharging patients, according to Ben Popkin, the legal counsel for Goodwin’s office. That’s because PBMs are based outside of North Carolina, where Goodwin has no jurisdiction.
So legislators took things in their own hands, adding a proposal to another bill that would penalize PBMs that jack up the price of a medication or keep prices higher if there’s a nationwide price reduction.
Once McCrory signs the bill, the penalty will go into effect in July 2016.
EpiPens in child-care facilities
During the last biennium, the legislature decided to require schools to have epinephrine auto-injector pens on hand in order to respond to a child having an allergy emergency. Lawmakers also appropriated funds to supply schools with the pens, mandated training for school personnel in how to use them and limited the liability for a person administering epinephrine via one of the devices to a child having an anaphylactic reaction to an allergen such as peanuts.
This year, lawmakers have extended many of the same provisions to other organizations and facilities that serve children, such as youth sports leagues, day-care facilities, amusement parks, restaurants and camps.
House bill 647 had an easy legislative journey early in the session, when it took only a week to go from introduction to passage in the House of Representatives. But after the bill went to the Senate, it languished until Monday, when it was sprung loose from the Senate Rules committee.
“This is a bill we passed 115-1,” bill sponsor Rep. Chuck McGrady (R-Hendersonville) told his fellow members of the House on Tuesday afternoon. “It has now cleared the Senate unanimously.”
The bill is on its way to McCrory’s desk, where he’s expected to sign it.
Funds for special-education scholarships
In 2010, the legislature passed a measure to help families who transfer their children with special needs from public to nonpublic schools, providing them with a $3,000 per-semester tax credit for their education.
But there’s been high demand for the scholarships, and now there’s 500 kids on a waiting list.
This past year, the legislature supported raising that amount to $4,000 per semester and also added the ability to allow direct payment to nonpublic schools.
But the money to assist families on the waiting list was not allocated, an amount that would total about $2.8 million.
A provision to get that money into the technical corrections bill failed. Advocates said they’ll be back next year.
Food stamps for rural unemployed
This measure to cut back on extended food stamp benefits to the long-term unemployed, was tucked into a larger bill that limits the rights of undocumented immigrants; the timing of the bill proved to be one of the sticking points of the last night of the session.
The controversial Protect North Carolina Workers Act (House Bill 318) garnered heavy debate on Tuesday afternoon and evening in the House of Representatives, where it passed, 70-43, along party lines.
Later in the evening, Rep. Verla Insko (D-Chapel Hill) successfully sponsored an amendment to a separate bill, the annual “technical corrections” bill, which changes the date in HB 318 on which the measure limiting access to the Supplemental Nutrition Assistance Program (commonly known as food stamps) for the long-term unemployed living in rural counties would go into effect.
“The county [department of social service] directors said that all of the programs they had in place to have job fairs, do job training and connect people who were unemployed with employers were cut during the recession,” Insko told the House. “They need a year to get them up and running.”
Insko argued that the implementation date should be pushed to October 2016.
House Bill 318’s original sponsor, Rep. George Cleveland (R-Jacksonville), told the body the Senate had worked out an arrangement with DHHS for a March 1 date.
“Then late this afternoon, I got an email from DHHS saying they’d prefer July. Now Rep. Insko wants to move it up to the first of October,” he said. “It’s a typical example of who can we get to give us the most of what we want.”
Despite Cleveland’s objections, the House voted with Insko to move the effective date to October.
When asked who requested the date change, Insko said, “No one.”
She said she’d talked to the head of DHHS’ Division of Social Services and several county DSS heads, and figured she’d give them a hand.
The problem was, the Senate was only willing to go so far.
As negotiations over the final shape of the technical corrections bill dragged on through the evening, Adam Sholar, DHHS’ attorney, was in and out of conference committee rooms to talk about the date. He said DHHS would be able to cope with a July 1 effective date.
In the end, that’s what the Senate agreed to and what made it into the final bill.
If it sounds confusing, it was.