SB 17 and Drug Pricing’s Impact on Plan Premiums
Panel
Panel 3: Drug Cost and Access I
Moderator
Paul Subar, Associate Professor and Chair of Department of Diagnostic Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry
Description
This presentation will primarily focus on the key findings of the Department of Managed Health Care’s (DMHC) report on Prescription Drug Cost Transparency for measurement year 2017 as required by Senate Bill (SB) 17 (Hernandez, Chapter 603, Statutes of 2017). In 2017, California enacted SB 17 with the purpose of increasing transparency of prescription drug costs. Specifically, SB 17 requires health plans that file rate information with the DMHC to report specific data related to the costs of covered prescription drugs beginning in October 1, 2018, and annually thereafter. Health plans must report the 25 most frequently prescribed drugs, the 25 most costly drugs by total annual plan spending, and the 25 drugs with the highest year-over-year increase in total annual plan spending. As part of this bill, the DMHC was also required to compile this information into a public report that summarizes the overall impact of prescription drug costs on health plan premiums. In December 2018, the DMHC issued its first annual report, representing information from 25 health plans and approximately 148.1 million member months.
Location
Pacific McGeorge School of Law, Lecture Hall, 3200 Fifth Ave., Sacramento, CA
SB 17 and Drug Pricing’s Impact on Plan Premiums
Pacific McGeorge School of Law, Lecture Hall, 3200 Fifth Ave., Sacramento, CA
This presentation will primarily focus on the key findings of the Department of Managed Health Care’s (DMHC) report on Prescription Drug Cost Transparency for measurement year 2017 as required by Senate Bill (SB) 17 (Hernandez, Chapter 603, Statutes of 2017). In 2017, California enacted SB 17 with the purpose of increasing transparency of prescription drug costs. Specifically, SB 17 requires health plans that file rate information with the DMHC to report specific data related to the costs of covered prescription drugs beginning in October 1, 2018, and annually thereafter. Health plans must report the 25 most frequently prescribed drugs, the 25 most costly drugs by total annual plan spending, and the 25 drugs with the highest year-over-year increase in total annual plan spending. As part of this bill, the DMHC was also required to compile this information into a public report that summarizes the overall impact of prescription drug costs on health plan premiums. In December 2018, the DMHC issued its first annual report, representing information from 25 health plans and approximately 148.1 million member months.
Speaker Bio
Jenny Mae Phillips is the Deputy Director of Legislative Affairs at the Department of Managed Health Care. The Legislative Affairs unit is responsible for analyzing proposed, pending and recently enacted legislation on behalf of the Department, and advising the Department on any and all legislative matters relating to the Knox-Keene Health Care Service Plan Act. The Deputy Director of Legislative Affairs also serves as a liaison to the Legislature, legislative staff, and legislative advocates, as well as serving as a resource for the California Health and Human Services Agency and the Governor's Office.
Prior to her appointment, Ms. Phillips served as senior attorney for the Department's Office of Plan Licensing, acting as the Department's liaison with Covered California and as lead attorney overseeing the health plans' annual timely access reporting. Before joining the Department, she served as counsel for the Managed Risk Medical Insurance Board where she worked on the Healthy Families Program and the Pre-Existing Condition Insurance Program. Prior to her work as a public servant, Ms. Phillips was in private practice, specializing in health care litigation.
Phillips graduated with honors from McGeorge School of Law in 2007 and received her Master of Laws in Public Law and Policy in 2008.