2023 Senate Bill 485

Senate Fiscal Agency Analysis

Senate Bill 483 (S-1) would create the Prescription Drug Affordability Board (Board) and the Prescription Drug Affordability Stakeholder Council (Council). The Board would have to select prescription drug products based on specified criteria and costs and determine whether to conduct cost and affordability reviews for those products based on their average patient cost share. Upon review, the Board could decide to establish an upper payment limit on a prescription drug product, which is a cap on the amount that a prescription drug purchaser or payer could pay for the product. The bill also would allow the Attorney General to pursue civil actions for a violation of an upper payment limit and subject the bills' provisions to appropriation. The other two bills would require insurers in the State and the Healthy Michigan Plan to comply with upper payment limits on prescription drug products. Senate Bill 484 would amend the Insurance Code to require an insurer that offered health insurance policies in the State to comply with upper payment limits established under Senate Bill 483 (S-1). Senate Bill 485 would amend the Social Welfare Act to require the Medical Assistance Program (Medicaid) to comply with upper payment limits established under Senate Bill 483 (S-1).