August 20, 2018
To the Honorable Members of
The Illinois House of Representatives,
100th General Assembly:
Today I veto House Bill 4096 from the 100th
General Assembly, which would severely restrict the State’s ability to
effectively manage the pharmaceutical costs of its Medicaid program.
This administration is committed to
maintaining an effective and efficient program of public aid to best serve
Illinoisans who utilize it while also ensuring its long-term viability. To that
end, we have launched a massive overhaul of the fee-for-service system that has
shifted our Medicaid program to a managed care model. This process has
achieved, and will continue to achieve, cost savings that allow the State to
better serve both the Medicaid population and other citizens of Illinois.
Unfortunately, this legislation would
undermine some of the innovative measures that were implemented to curb program
costs by limiting the Department of Health and Family Services’ (HFS) control
over managed care organizations’ preferred drug lists (PDLs). This legislation
prohibits the Department from requiring that MCOs only cover certain
pharmaceuticals as preferred and from requiring participation in a universal
preferred drug list. Further, the Department would not be allowed to prohibit a
health plan from negotiating with drug manufacturers for drug pricing
concessions or rebates on any drugs on the classes of drugs on the preferred
drug list.
One of the elements the State specifically
sought in its procurement of qualified managed care organizations was
willingness to participate in a robust drug rebating program that necessitates
limiting preferred drug lists of health plans. This system ensures access to
clinically effective and appropriate drug therapies while maximizing federal
and supplemental rebates. Deviating from this program as conceived would cost
the State tens of millions of dollars in lost rebating opportunities.
We are proud to be managing the State’s
resources and maximizing opportunities for cost savings while serving our
Medicaid population to the greatest extent possible. It would be a disservice
to taxpayers and participants to create barriers to the progress and potential
of this recently reformed program with restrictions such as these.
Therefore, pursuant to Section 9(b) of Article
IV of the Illinois Constitution of 1970, I hereby return House Bill 4096, entitled
“AN ACT concerning public aid,” with the foregoing objections, vetoed in its
entirety.
Sincerely,
Bruce Rauner
GOVERNOR