Prescription Drugs

Maine has been a leader in the effort to make prescription drugs more affordable. In addition to the assistance programs operated by Maine, the state has passed laws that work to protect the integrity of the prescription drug marketplace.

The role of the Office of Attorney General in this area includes assisting the State in faithfully applying the standards of its drug assistance programs and in ensuring that Maine's laws are fairly and effectively enforced.

I. Helping You With Your Prescription Drugs

Your income and age, and other factors such as military status, may qualify you for assistance from a federal or Maine program with your prescription drug costs.

MaineCare, which is Maine's Medicaid program, includes the largest prescription drug program operated by the state, but the state also operates the Maine Drugs for the Elderly Program and the Maine Rx Plus Program.

The Maine Drugs for the Elderly Program provides "wrap around" benefits to people who are eligible for both MaineCare and the Medicare Part D prescription drug program and to other qualified Medicare beneficiaries. Maine's safety net program comes into play if the federal program fails to perform in some manner.

The Maine Rx Plus Program enables qualifying Maine residents to obtain discounts on prescription drugs that are based on rebates negotiated by the State with drug manufacturers.

Information about MaineCare and the other prescription drug programs is available on the website of the Maine Department of Health and Human Services at:

http://www.maine.gov/dhhs/beas/medbook.htm#medicare_coverage and at http://www.maine.gov/dhhs/prescription_drugs.shtml.

If you have more questions about paying for prescription drugs, you can contact the State Health Insurance Assistance Program (SHIP). This statewide service provides information and assistance with Medicare, supplemental insurance (Medigap), Medicare Prescription Drug Coverage, Medicare Savings Programs, MaineCare and other kinds of health insurance issues. The staff will help with application forms and guide you through the process.

You can talk to a SHIP counselor over the phone, at the office, or in your own home. No fees are charged, and all information is kept private. An interpreter will be provided if you need one. To get in touch with a SHIP counselor, call your local Area Agency on Aging at 1-877-353-3771 or the Legal Services for the Elderly Helpline at 1-800-750-5353 (Voice and TTY).

The MaineCare rules governing prescription drug coverage are located in Chapter II, Section 90 of the MaineCare Benefits Manual (which is Chapter 101 of the Maine Department of Health and Human Services (DHHS) rules), or on the web at: http://www.maine.gov/sos/cec/rules/10/144/ch101/c2s080.doc.

More general rules governing MaineCare services are in Chapter I of the MaineCare Benefits Manual (Chapter 101 of the DHHS rules) and are available on the web at http://www.maine.gov/sos/cec/rules/10/144/ch101/c1s.doc.

Rules governing the Maine Drugs for the Elderly Program and the Maine Rx Plus Program are available online at: http://www.maine.gov/sos/cec/rules/10/chaps10.htm. Look under Chapter 104 of the DHHS rules (Chapter 104 is the Maine State Services Manual).

II. Protecting the Marketplace

The Attorney General's Office has enforcement authority over Maine statutes and rules that apply to companies that manufacturer prescription drugs and that apply to pharmaceutical benefit managers.

Many drug manufacturers are required by Maine statute and rules to report their marketing expenses within Maine and in regard to Maine prescribers. Manufacturers must file an annual report by July 1 of each year. The statute (22 M.R.S.A. §2698-A) can be viewed online at: http://janus.state.me.us/legis/statutes/22/title22sec2698-A.html. The rules implementing 22 M.R.S.A. §2698-A are located in Chapter 275, Section 1 and are available online at: http://www.maine.gov/sos/cec/rules/10/144/144c275-section-2.doc.

Many drug manufacturers are required by Maine statute and rules to register online their clinical drug trials and report the drug trial results on an online web site. Because the Maine requirements do not apply until an FDA-approved drug reaches Maine, many clinical drug trials may be registered only after their completion. Drug manufacturers have until April1, 2008 to complete the registration and results reporting for past years of trials initiated on or after October 15, 2002. Links to trial registrations and to the trial results may be found at: http://www.maine.gov/dhhs/boh/clinical_trials.htm.

The statute requiring the posting of drug trial information is 22 M.R.S.A. §2700-A and can be found online at: http://janus.state.me.us/legis/statutes/22/title22sec2700-A.html. Rules implementing the statute were jointly adopted by the Maine Department of Health and Human Services and the Office of the Attorney General and can be found online at: http://www.maine.gov/sos/cec/rules/10/144/144c275-section-1.doc.

Maine also regulates by statute the conduct of Pharmaceutical Benefit Managers. That statute imposes a fiduciary duty on Pharmaceutical Benefit Managers to the health plans with which they contract. That statute, 22 M.R.S.A. §2699, may be found online at: http://janus.state.me.us/legis/statutes/22/title22sec2699.html.