HELENA - Gov. Brian Schweitzer, who last month asked the federal government to approve a "waiver" so Montana could import prescription drugs at lower cost for state-funded health plans, has not submitted any of the usual documentation that accompanies such a request, his administration acknowledges.
The governor sent only a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, asking that her agency grant Montana a "Medicaid waiver" allowing importation of lower-cost drugs from Canada.
"We have to work through the secretary's office," says Anna Whiting Sorrell, director of the state Department of Public Health and Human Services. "There is not another state that has requested this. We think the governor is forging a new path."
Medicaid is the state-federal program that pays medical bills for the poor, and Schweitzer proposed that Montana be allowed to import Canadian drugs primarily for use by Medicaid patients.
A spokeswoman for the Center for Medicaid and Medicare Services in Washington, D.C., said last week that requests to "waive" or amend Medicaid programs usually are accompanied by extensive documentation, explaining how the waiver will provide the same or better service at a lower cost.
"A simple letter to the secretary is not a formal waiver request," said Mary Kahn. "We have forms that ask for specific information, (such as) how you would plan to run it, how it would be cost-neutral."
Kahn also said the U.S. Food and Drug Administration, another division of Health and Human Services, has jurisdiction over whether certain drugs can be imported to the United States.
"The monkey wrench is that the FDA is involved," she said. "We'd have to get a ruling from them as to whether these drugs can even be used in this country."
The FDA, after several inquiries to its office in Silver Spring, Md., would not comment and referred questions back to the HHS main media office.
Sorrell said her office is waiting to hear back from HHS Secretary Sebelius' office on the governor's request.
Kahn said last week that Sebelius has Schweitzer's letter "under consideration" and that no formal decision has been made.
Schweitzer sent his letter on March 11, asking the Obama administration "to join me in my fight against unfair drug pricing by granting a Medicaid waiver allowing us to import prescription drugs from Canada" for Montanans in its correctional system and those covered by Medicaid, the Healthy Montana Kids program and the state employee health plan.
The governor estimated that importing lower-priced drugs from Canada would save the state about $40 million a year on its $100 million drug costs in those four programs.
The four programs cover about 160,000 people in Montana, or about one-sixth of the state's population.
The governor said last month the state could buy some of the drugs directly from wholesalers in Canada, or place the orders and have them delivered to pharmacies around the state for purchase by people covered by publicly funded health plans.
Missoulian State Bureau reporter Mike Dennison can be reached at 1-800-525-4920 or at firstname.lastname@example.org.