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SB 485

Human services: medical services; compliance with the prescription drug cost and affordability review act; require. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109o. TIE BAR WITH: SB 0483'23

2023-2024 Regular Session Introduced by Sarah Anthony and 17 co-sponsors

Michigan requires Medicaid to apply prescription drug affordability standards when deciding which medications to cover under state health programs.

referred to Committee on Insurance and Financial Services
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Bill Summary · SB 485

Legislative bill overview

SB 485 amends Michigan's public assistance law to require the state's human services department to comply with the Prescription Drug Cost and Affordability Review Act when making medical service coverage decisions. The bill ties to SB 483, suggesting coordinated legislative action on prescription drug pricing oversight and Medicaid coverage determinations.

Why is this important

This bill directly affects which prescription drugs Michigan's Medicaid program covers and at what cost, potentially impacting access to medications for hundreds of thousands of low-income residents. It creates a formal mandate to apply affordability criteria rather than relying solely on clinical or budgetary justifications, which could influence drug pricing negotiations and coverage denials.

Potential points of contention

  • Costs vs. access trade-off: Stricter affordability reviews might exclude expensive medications, limiting patient options but potentially controlling state healthcare spending
  • Implementation burden: The Department of Health and Human Services must establish compliance mechanisms and review processes, requiring new resources and administrative capacity
  • Pharmaceutical industry impact: Drug manufacturers may face restrictions on pricing or coverage that could affect their Michigan market strategy and profitability

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

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