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LD 697

An Act To Direct The Maine Prescription Drug Affordability Board To Assess Strategies To Reduce Prescription Drug Costs And To Take Steps To Implement Reference-Based Pricing

132nd Legislature (2025-2026) Introduced by Donna Bailey and 5 co-sponsors

Directs Maine's Prescription Drug Affordability Board to assess strategies to cut drug costs and begin implementing reference-based pricing, with OHAC staffing and data support.

Became Law without Governor's Signature
#affordabilityboard #costreductionstrategies #prescriptiondrugs
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Bill Summary · LD 697

LD 697 — Summary

Title: An Act To Direct The Maine Prescription Drug Affordability Board To Assess Strategies To Reduce Prescription Drug Costs And To Take Steps To Implement Reference-based Pricing
Bill No.: LD 697
Introduced: February 20, 2025
Status: Held by the Governor (07/08/2025)

Purpose

LD 697 directs the Maine Prescription Drug Affordability Board to (1) evaluate strategies to reduce prescription drug costs and (2) take steps toward implementing reference‑based pricing for prescription drugs. The statute is intended to give the Board authority and resources to analyze pricing options and begin operational steps toward alternative payment benchmarks.

Key provisions

  • Requires the Prescription Drug Affordability Board to assess and recommend strategies to reduce prescription drug costs.
  • Directs the Board to take steps to implement reference‑based pricing (i.e., establishing reimbursement benchmarks tied to an external reference rather than usual billed charges). The bill text does not specify a particular external benchmark.
  • Authorizes the Office of Affordable Health Care to support the Board’s work through staffing, administrative support, subscriptions for commercial drug pricing data, and contracted consulting for data analysis.

Fiscal impact (summary of fiscal notes)

Two fiscal notes were issued for differing amendment stages:

  • Fiscal Note (04/14/2025) for the Committee amendment:

    • Ongoing General Fund appropriations to the Office of Affordable Health Care of $223,422 (FY 2025‑26) and $298,362 (FY 2026‑27).
    • Funds two positions: one Public Service Manager III and one Comprehensive Health Planner II, plus related "All Other" costs for data subscriptions and consulting.
    • Staffing and contracting support effective October 1, 2025.

  • Fiscal Note (06/24/2025) for Senate Amendment to the Committee amendment:

    • Removed ongoing General Fund appropriations of $85,605 (FY 2025‑26) and $119,244 (FY 2026‑27) for one Comprehensive Health Planner II and related costs (shown as savings in the note).
    • This amendment reduces the overall appropriation required (the final net appropriation after amendment was not shown in a single combined note but can be inferred by subtracting the removal amounts from the earlier estimate).

Who is affected

  • State government: Office of Affordable Health Care (staffing and contracts), Prescription Drug Affordability Board (expanded responsibilities), and the General Fund (appropriations).
  • Payers and purchasers: private insurers, employer plans, and potentially state programs if the Board’s recommendations influence coverage or reimbursement policies.
  • Providers, pharmacies, pharmacy benefit managers (PBMs), and drug manufacturers: could be affected if reference‑based pricing or Board recommendations change reimbursement levels or contracting practices.
  • Consumers: potential for lower out‑of‑pocket drug costs if strategies are implemented successfully, though outcomes will depend on subsequent rulemaking or payer adoption.

Legislative and procedural status

  • Referred to the Committee on Health Coverage, Insurance and Financial Services (02/20/2025).
  • Committee amendment (A / S‑159) adopted by both chambers; Senate amendment (A / S‑459) further amended the committee amendment.
  • Passed both chambers and “Passed to be Enacted” (06/25/2025).
  • Final status: Held by the Governor (07/08/2025).

Notes and next steps

  • The bill sets a framework for study and initial implementation steps; substantive effects (e.g., formal adoption of a reference benchmark, changes to payer reimbursement) would depend on the Board’s findings and any implementing rules or statutory follow‑on actions.
  • The effective availability of Board staffing and data resources was tied to appropriations and an anticipated start date for administrative support of October 1, 2025 (per fiscal note).

Compiled from official sources — confirm details with the bill’s official record.

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