Latest news with #House-Senate
Yahoo
01-07-2025
- Business
- Yahoo
Ohio pharmacy measure will make closures ‘explode,' group says
A pharmacy manager retrieves a bottle of antibiotics. (Photo by) Compromise budget language hashed out this week by an Ohio House-Senate committee will make problems hurting Ohio pharmacies infinitely worse, the leader of a group that represents them said Thursday. He added that the Ohio Chamber of Commerce — which advocated part of the legislation — seemed blind to the effect it would have on member businesses by making it more difficult for employees to access medicine. As it works against a June 30 budget deadline, a House-Senate conference committee approved an amendment that keeps part of a bill meant to help ailing pharmacies but slashes another. The result, said Dave Burke, a pharmacist, former state senator, and executive director of the Ohio Pharmacists Association, will be that pharmacies will go from earning scant profits to none at all. 'It's any pharmacist's suicide bill,' he said Thursday. Ohio pharmacies have been in trouble for years. They've complained of high fees and low reimbursements from huge middlemen known as pharmacy benefit managers, or PBMs. Last year, Ohio lost 215 pharmacies and their total number dropped below 2,000 for the first time in memory, according to an online tracker launched by the Ohio Board of Pharmacy. As pharmacies disappear, they create a lack of access that is particularly hard on the poor, elderly and disabled. Not only do they get their medicine at what are often main-street businesses. They also get professional medical advice about chronic conditions like diabetes and high blood pressure. PBMs, the middlemen, decide which drugs are covered, and they use a non-transparent system to decide how much to reimburse pharmacies that dispense them. The three biggest control nearly 80% of the marketplace. As pharmacies close, Ohio Chamber blasted for siding with middlemen Each of those companies is part of a Fortune 15 health conglomerate that also owns a top-10 health insurer. CVS owns the largest retail pharmacy chain and all three own mail-order pharmacies. So, when the big PBMs decide reimbursements, impose rules and charge fees, they're doing so for their own pharmacies and their competitors. That's a glaring conflict of interest, their critics say. There have been abuses in Ohio. In 2018, the Ohio Department of Medicaid peeled back the curtain and learned that a year earlier CVS and UnitedHealth's PBM, OptumRx, charged taxpayers $224 million more for drugs than they paid the pharmacies that had dispensed them. The Medicaid department fired the PBMs. In 2022 it got rid of their hidden, seemingly arbitrary system of reimbursement in which the same companies sometimes pay 500 different prices for the same drug. Instead, prices are determined by a public survey published by the U.S. Centers for Medicare and Medicaid Services — the National Drug Acquisition Cost, or NADAC. With pharmacies no longer losing money on some drugs and making it on others, the Medicaid department set a $10 per-prescription dispensing fee to cover pharmacies' overhead. Even with the increased dispensing fees, an analysis said the state saved $140 million from the reforms. Ohio state Rep. Tim Barhorst, R-Fort Laramie, this year proposed to use the same arrangement in many non-Medicaid transactions. That measure made it into the Ohio House budget, but then ran into opposition in the Ohio Senate, where the Ohio Chamber had been telling members the dispensing-fee requirement was a tax. What emerged from the conference committee late Wednesday might have seemed like a compromise to its members. It kept the provision that drug reimbursements would be based on NADAC, the publicly available price list, but it got rid of dispensing fees. To Burke and other Ohio pharmacists, it's the worst of both worlds. Not only couldn't they profit from over-reimbursements under the traditional, non-transparent system, they also couldn't cover overhead from a fixed dispensing fee. Of the measure agreed to by the conferees, Burke said, 'That proposition only works with a second proposition — the dispensing fee. Because the bag, the bottle, the lid, the pharmacist, the tech, the lights, the heat and the air conditioning all have a cost. In any business model, whether it's medications, pizzas or cars… you can't buy ingredients for a dollar and sell pizzas for a dollar and stay in business.' He predicted that if it becomes law, there will be a mass exodus from the already depleted ranks of Ohio pharmacies. 'If pharmacies can't make any money — this legislation makes it so that you're not making any money at all — it would probably force the closure of the overwhelming majority of pharmacies in this state,' Burke said. 'Even a child mowing yards is not going to buy a dollar's worth of gas and accept a dollar to mow your yard.' Once conferees agree on a budget, Gov. Mike DeWine has the power to veto line-items in it. Burke said he hoped the governor would consider such a move. 'I think the governor's office would be well placed to consider a veto and we will be expressing our concerns that the legislation is flawed, and that if he doesn't, the amount of pharmacy closures in Ohio in the next weeks if not months will explode,' Burke said. Dan Tierney, DeWine's press secretary, was non-committal when asked about the matter. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'We have not received final budget language but will be reviewing the final language when received,' he said in an email Thursday. Burke didn't accuse any of his former colleagues of ill-intent in agreeing to the measure. 'I think they believed that if they stepped in and said we'll make sure you get paid what you paid for the drug that will fix everything,' Burke said. 'But this legislation takes everything you made a profit on and brings it to zero.' However, he did say he was mystified about the Ohio Chamber's reasons for intervening in the matter. 'I don't know where the chamber adopted its stance from, but it's hard for me, as an independent business owner, to understand why major employers would want to increase their employees' difficulty getting medications.' Burke was incensed that the Ohio Chamber would call dispensing fees — payments to cover overhead — a tax. 'It's amazing to me that the chamber should take the position that business owners should not make a profit,' he said. 'I thought the Ohio Chamber was all about profit, pro-business and competitive markets. But they've adopted the position that this particular sector of business owners should not make any money. They consider the dispensing fee to be a tax. So apparently, any profit that any business makes is a tax. Maybe they've gone socialist over there. I don't understand. Maybe they're not looking at their own pharmacy benefit with any understanding.' The Ohio Chamber didn't immediately respond Thursday to a request for comment. But earlier this week, Senior Vice President Rick Carfagna said the goal was to protect Ohio businesses from paying too much to underwrite employees' drugs. There are, however, questions about the body's relationship with the giant conglomerates that own the PBMs. For example CVS Health was a 'presenting sponsor' of the Chamber's 2024 Healthcare Summit, Among the questions the Ohio Chamber didn't immediately respond to was how much CVS paid to sponsor the event — or how much the chamber had received from the big-three conglomerates over the past five years. In earlier responses, Carfagna didn't address the growing number of pharmacy deserts in Ohio, or that struggling independent and small-chain pharmacies are themselves small businesses that the Ohio Chamber says it wants to protect. Burke said all the Ohio Chamber's members will be harmed if the conference committee language becomes law and mass closures result. That would mean sicker employees with difficulties getting medicine. 'I hope the Chamber actually goes and speaks with the people they're supposed to represent and see if this policy position is reflective of the way they want to treat their employees,' Burke said. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Yahoo
11-06-2025
- Politics
- Yahoo
Advocates for disabled criticize proposed voting changes
Advocates for the disabled charged that two pending election law bills would create unfair barriers for those seeking to vote by absentee ballot or to use accessible voting equipment to cast a ballot in person. But supporters insisted the voter identification requirements for those voting by absentee ballot should be as rigorous as those who vote in person at the polls. They maintain that small towns should not have to lease expensive accessible voting equipment if there aren't going to be any voters who need those services on Election Day. Dr. Randy Pierce is chief executive officer with Future in Sight, an advocacy group that assists the 29,000 residents in New Hampshire who are blind or visually impaired. 'What these result in are creating a barrier and in New Hampshire voting should be a private, independent and undue barrier-free system,' Pierce said. 'The good news is this is not too late.' Both the absentee voting (SB 287) and accessible voting (HB 613) bills are expected to go to a House-Senate conference committee to try and settle differences between the two measures. Currently, anyone can request by mail an absentee ballot application and then mail in their vote to the city or town clerk. The absentee voter has to sign an affidavit under penalty of perjury that he or she qualifies as a resident and eligible voter in that precinct. Late last month, the House Election Laws Committee attached to a related absentee ballot bill the proposed requirement that a copy of the voter's photo identification card and a notarized signature on the application form would be required to receive an absentee ballot. Chairman and state Rep. Ross Berry, R-Weare, said concerns about the mandate were overblown. 'Importantly, New Hampshire law currently allows for electronic and remote notarization services, providing an additional, accessible option for voters to verify their identity remotely,' Berry said. 'Voters who request an absentee ballot in person may simply present their ID at the clerk's office. During committee discussions, it was noted that electronic transmission methods — such as emailing a scanned copy of an ID — would be acceptable, as New Hampshire law currently imposes no requirements for ID submission.' Critics liken bills to voter suppression Rep. Connie Lane, D-Concord, said there's no valid reason for imposing the requirement. 'This bill, like many others passed over the past few years, is based purely on speculation and adds yet another barrier to exercising the right to vote — also known as voter suppression,' Lane said. The House passed the bill along party lines, 184-146 with GOP members in support and Democrats against it. Sen. James Gray, R-Rochester, convinced the Senate last week to have his accessible voting language replace an unrelated measure about default town budgets. As crafted, it would permit any city or town clerk to notify Secretary of State David Scanlan that it will not need to acquire accessible voting equipment unless a local voter asks for it within 60 days of an election. James Ziegra, senior staff attorney with the Disabilities Rights Center, said the change is unconstitutional and would be in violation of federal law as well. Pierce said his members reside in 'every town and city ward' in New Hampshire so all communities should the accessible machines available. 'No one in this state should have to fight to have their vote counted and heard,' added Krysten Evans, director of policy and advocacy for ABLE NH, an interest group that supports the disabled. What's Next: Both bills will be discussed before House-Senate conference committees next week and face a June 19 deadline to reach an agreement. Prospects: Given the support among House and Senate Republican leaders for these changes, odds are high that they are going win approval in the Legislature during these final weeks. klandrigan@
Yahoo
02-06-2025
- Business
- Yahoo
Down to the wire: Setback for Paxton, no deal on voting bill ahead of final session's day
Sunday was the second to the last day of the 2025 legislative session, and more importantly, the final day to push legislation over the finish line and onto the desk of Gov. Greg Abbott. Much of the action in both chambers focused on measures not identified as priorities of either Abbott or legislative leaders. But a few pieces of significant legislation were debated and a couple of priorities of top state leaders fell by the wayside. Typically, the final day of the legislative session is mostly ceremonial. Legislation that would have granted state district judges their first pay raise in a dozen years has appeared to fall victim to a House-Senate standoff in closing days of the session. But some members of the House and Senate spent Sunday trying to put a deal together in the effort to pass on the final day of the session. It would require suspending several rules, but it could be done. Senate Bill 293 passed the House last week without much controversy after the sponsor, state Rep. Jeff Leach, R-Plano, made clear that members would not be voting themselves a backdoor increase to the pensions they earn for extended service in the Legislature. Lawmakers' pensions would still be calculated as if judges' pay remained $140,000 per year, and not at the $175,000 the bill would have paid judges. Under state law, lawmakers are paid only $7,200 a year. However, once they reach eight years of service, they are eligible for state pension that is in line with a salary-linked pension that judges can draw. The more years of service, the more valuable the pension of judges — and lawmakers — is. When SB 293 returned to the Senate, the upper chamber sought to nullify the decoupling of judge-lawmaker pensions without consulting the House. With the legislative session ending Monday, the two chambers would have to agree on SB 293 by midnight Saturday. That deadline came and went with no deal on the bill. Stay tuned. A proposal that would have granted Attorney General Ken Paxton new powers to enforce Texas' election laws died on Sunday after House and Senate lawmakers failed to reach a compromise. The Senate's expansive version of House Bill 5138 would have empowered Paxton to prosecute any election code violation at any time. In contrast, the House version allowed the attorney general to take on election fraud cases only if the local district attorney waited more than six months to prosecute. The legislation was all but certain to face legal challenges if it went into effect. The all-Republican Texas Court of Criminal Appeals struck down a similar law in 2021, ruling that the state Constitution forbids the executive branch from taking on the judicial-branch duty of prosecuting crimes. District attorneys are considered to be part of the judicial branch, while the attorney general is not. Legislation that would have required proof of citizenship to register to vote was left languishing as the clock was running out of the session. Though state and federal law already prohibits noncitizens from voting, Senate Bill 16 filed by Mineola Republican Sen. Bryan Hughes would have required voters to prove their citizenship to their local voter registrar. The bill sought to create a bifurcated voter registration system and would require applicants and already-registered voters to provide a document like a birth certificate, passport or naturalization certificate to be eligible to cast a ballot in state or local elections. If a voter does not provide citizenship documents, they would be able to vote only in federal races. Legislation to broaden the umbrella of the state's medical marijuana program to including chronic pain and Crohn's disease was sent to the governor. If signed into law, House Bill 46 would allow patients eligible for the state's medical marijuana program to use products like cannabis patches, lotions, prescribed inhalers and vaping devices. The list of qualifying conditions would also expand to include chronic pain and terminal or hospice care. This article originally appeared on Austin American-Statesman: Texas legislative session ends Monday. Here's what's left to finish
Yahoo
01-06-2025
- Business
- Yahoo
Down to the wire: A $338B Texas budget, new rules for faculty senates at universities
Day 138 of the 140-day session of the Legislature resembled a volleyball game where the ball was the scores of bills trying to make through the process and the net was the Capitol rotunda that separates the House from the Senate. Here are some of the highlights from Saturday's action. Both Houses signed off on the $338 billion spending plan to fund state government for the two-year cycle that begins Sept. 1. The total — the product of negotiations and compromises hammered out by a House-Senate conference committee — was slightly more than either chamber proposed when each passed its own version of the budget. The spending plan, which is subject to certification by Comptroller Glenn Hegar, includes $65 billion for the state's sundry education programs and $44 billion for health and human services programs. Assuming that certification is granted, Gov. Greg Abbott can either sign it into law or veto it. A third option for Abbott is the line-item veto that allows the governor to redline individual appropriations if he chooses. The budget represents an increase of 1.2% from the present two-year budget. The document would also, to some degree, tap the breaks on Abbott's border security plan known as Operation Lone Star, which so far has cost Texas taxpayers more than $11 billion since 2021. The 2026-27 budget would allocate $3.4 billion for border security. That's down from about $6.5 billion proposed in the chambers' earlier versions. Now that President Donald Trump has returned to the White House, federal allocations for border security are expected to be stepped up. Both chambers have approved and sent to the governor, sweeping legislation that seeks to limit faculty authority over university governance. The bill also expands the governor-appointed board of regents' control over core curriculum, degrees and hiring, and create an investigative office to handle complaints of noncompliance against universities. The bill also includes provisions to initiate a review of all core courses to ensure alignment with workforce readiness and prohibits any required class from advocating or promoting the idea that one race, sex, religion or ethnicity is "inherently superior to any other." Public school students would no longer be allowed to use cellphones in school under legislation that is now on its way to the governor. House Bill 1481 would allow local school boards to decide how the law would be applied. Exemptions would be available for students who require phones for medical and personal safety purposes. If Abbott signs the measure, students could not use their cellphones during the school day. Here's how the Texas Legislative Reference Library explains the process by which the governor signs or vetoes bills that pass both chambers and arrives at his desk: "Bills that pass the House and Senate are sent to the Governor to sign or veto. The Governor has 10 days (not counting Sundays) to return the bill to the Legislature with objection. If after 10 days the bill is not returned to the Legislature by the Governor with objections, the bill becomes law as if the Governor had signed it. "If the Legislature has adjourned sine die, or if the bill is presented to the governor less than 10 days (not counting Sundays) prior to final adjournment, the Governor has 20 days (counting Sundays) after the final day of the session to sign or veto the bill. If neither action is taken, the bill becomes law without the Governor's signature." The last day in the process this go-round is June 22. This article originally appeared on Austin American-Statesman: Texas Legislature tries to pass last bills in the final weekend
Yahoo
20-05-2025
- Politics
- Yahoo
Preliminary audit of YDC fund lacks any smoking gun
Anyone expecting that a preliminary audit of the Youth Development Center Settlement Fund would have an explosive, smoking gun finding is bound to be disappointed. Carson requested and Legislative Fiscal Committee ordered YDC fund audit Senate President Sharon Carson, R-Londonderry, requested and the Legislative Fiscal Committee approved a report reviewing the finances of the Youth Development Center Settlement Fund created in 2022 to consider damage awards to victims of alleged sexual and/or physical abuse. The 18-page report addressing seven bullet points the Legislative Fiscal Committee had called for at the urging of Senate President Sharon Carson does not cite any concern that the fund, created in 2022, has been improperly managed. Christine Young, director of audits under Legislative Budget Assistant Michael Kane, said four members of her team conducted interviews over the last four weeks of employees involved in the program with the Department of Justice (DOJ) and the YDC Claims Administration (YDCCA) staff group. They've also been reviewing all policies and reports. A final report from Young's group is due in early June. Carson said she requested the review because she didn't know enough about how the fund was dispensing awards, especially since June 2024 when a new law allowed fund administrator John Broderick and his legal team to pay out awards over time rather than in lump sums. The law allows awards to be paid in up to 10-year terms, but the report found that only five of 80 approved awards would be paid over 10 years, while 50 of the 80 awards will be paid out in four years or less. Awards already agreed to are going to cost the state budget at least $20 million in the two-year period that begins July 1, according to the report. The House-approved state budget has earmarked only $10 million for the fund in each of the next two years. Broderick has requested $150 million, which would equal the $75 million the fund is allowed to spend in any given year. Payments to lawyers Carson and other fiscal members raised questions about how lawyers representing the victims are paid. The report found the average attorney fee paid to date has been 30.8% of the award, below the 33% cap allowed by state law. Young's report confirms that 18 firms representing more than 75% of the victims have agreed to receive their fees over a three-year period. But the report found 50 claims had attorney fees totaling $11.2 million that had been paid in lump sums while their clients were all getting paid in installments. The report does reveal that Broderick has chosen not to act upon requests from Attorney General John Formella's staff for more fact finding on his cases. Preliminary financial report on YDC settlement fund released A House-Senate budget oversight committee approved an immediate audit into the finances of the state-created claims fund that approves damage awards to victims of sexual and physical abuse at the Youth Development Center in Manchester (pictured). The AG hired the Verrill Dana law firm of Portland, Maine, to review claims by the administrator to assess completeness and areas of agreement or disagreement. From 2022 to 2024, the AG had to provide its position whether it agreed 'fully or partially' with the administrator's claim decision. Since June 2024, that view from the AG has been optional though the practice 'remains substantially in place,' the report said. Young said the Verrill Dana firm has 'in certain cases' requested Broderick refer the case to a fact facilitator, but Broderick has not done so. 'YDCCA staff reported requests have not been granted by the administrator to conduct an additional independent investigation because statute requires timely processing of claims, and the resolution proceeding uses trauma-informed professionals to address verification and credibility questions in addition to controls throughout the claims process,' the report said. 'Contracts for these professionals include fact facilitation in the scope of work should it ever be needed.' Other details in the report included: * Inmate victims: Nearly one in five who have brought claims are currently prison inmates. Only 17 of those inmates are in out-of-state jails while the other 181 (91.4%) reside in New Hampshire prisons. * Administrative costs: Formella's staff spent 61.6% for the fund with the YDCCA has accounted for 38.4%. * Size of awards: The average award has been $543,000. Among the 296 completed claims, 54 of them were more than $1 million and 242 were less than that benchmark. klandrigan@
