Officials are unsure of how the prescription plan will be affected by Medicare reform.

AUGUSTA (AP) – A revised version of the Maine Rx law enacted by the Legislature to bring down the cost of prescription drugs will not go into effect this month as scheduled.

Maine Rx Plus, initially set to start Jan. 1 and help 275,000 Mainers, is on indefinite hold as the state figures out how the program will co-exist with Medicare reform enacted in Congress.

The Medicare reform offers a prescription drug benefit for the first time in the federal program’s 38-year history.

Trish Riley, the governor’s director of health policy and finance, said the legislation adopted in late November brings with it an array of unforeseen scenarios. And the state wants Mainers to be able to tap into the federal benefit before using the state program’s money.

“It’s an administrative negative,” Riley said of the Medicare complications. “But it’s not all negatives.”

With so many unknowns, Riley said it’s unclear when Maine Rx will be launched. Lawmakers are pushing for quick action.

Senate Majority Leader Sharon Treat said she is eager to see Maine Rx operating because constituents have told her they are putting off drug purchases until they can get Medicaid-like discounts from the program.

“My hope is by the end of January it could be up and running,” said Treat, D-Farmingdale, who was briefed about Maine Rx Plus on Friday afternoon by Riley.

The delay of Maine Rx Plus is just the latest hurdle for a program that has undergone numerous changes and faces continuing legal battles.

The program was born in 2000 as Maine Rx, and the state captured national attention for threatening to punish drug companies who refused to provide discounts for the program.

The state planned to put the products of uncooperative companies on a special list of drugs requiring doctors to seek “prior authorization” before prescribing them for Medicaid patients, a market that drug companies count on.

The trade group Pharmaceutical Research and Manufacturers of America successfully stalled the initial program, arguing that Maine was using the poor to extract discounts for better-off Mainers.

But the U.S. Supreme Court decided there was not enough reason to halt program. It lifted the injunction May 19, 2003, and sent the law back to U.S. District Court in Portland for review on its merits.

PhRMA has not sought another injunction, but on Dec. 31, 2003, it filed a motion requesting that the court seek the opinion of the secretary of the federal Department of Health and Human Services about the program, according to Assistant Attorney General John Brautigam.

The Baldacci administration has renamed the program Maine Rx Plus and softened features to protect it from future legal action.

The changes included eliminating open enrollment and adding the income-eligibility cap. The state program accepts people living within 350 percent of the official poverty level.

AP-ES-01-03-04 1430EST

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