00:00 Just as reminder everyone when drugs are priced there's the cost of the ingredients and there's also the dispensing, looks like the federal government is gonna require states to go down on the cost of the ingredients and what the senate did was to say alright increase the dispensing fees so that net there's a savings of 975 thousand dollars what the house said was make it budget neutral so as those ingredient costs go down raise the dispensing up so that the pharmacists are more or less kept whole, also the house version is conditional on the federal government actually requiring this whereas the senate version says January 1 2015 just go ahead with it. On page 344 there is a provision that was amended on the floor during debate on Thursday from the house and this is something that has two conditions on it one if there are savings in doing what I'm about to describe and then second the department may choose to do it there's an issue when we've got on the drug list preferred drugs which are brand drugs that the state actually net works better than the generics because there are certain rebates and so the prices are better on that than the generics and so there's a requirement that those drugs be dispensed sometimes though pharmacists can't get a hold of those preferred brands and so what this provision would do is if there are savings that the department may allow pharmacists to instead substitute the generic if they can't get the preferred there're some details on what the pharmacists would have to do they'd have to keep records they'd have to try within the two prior weeks but this is just something that would allow pharmacists to substitute some generic drugs in certain circumstances page 345 something that follows the money is in senate only that's mental health drug prior authorization Steve already mentioned this one this morning, page 346 both the senate and the house had something on studying personal care services or PCS but on page 346 you can see there're two subsections that were senate only Steve mentioned these this morning these were the sections that required the department to go back and recoup and then also make rate adjustments to further reduce the amount of cost for personal care services, one thing to know on page 348 there were couple things added to the study portion by the house just looking at the impact on any reform of personal care services any impact on appeals and legation and also there on lines 25 and 26 included within the study just the quality of resident care within adult care homes. Alright if you look at page 349 and also 350 if you kind of hold them open you can see two very very different approaches senator Mckissick this is actually what you asked about earlier this morning with the base rates the senate created a state wide base rate and what the house did was pull back from last year's budget where there was a director to the department to do the regional base rates the house pulled back from that and turned that into a study and so you can see a modification on page 350 modification on what was on last year's budget changing to that study page 351, 352 another couple that you probably wanna keep open at the same time so you can see this [??] with the supplemental payments that go to UNC and the ECU providers if you look on line 11 over on page 351 and line 8 you can see that the number of slots allowed for east Carolina university went from 375 to 418 that should really be considered a technical fix because we got updated information indicated that 418 was actually the number that had been receiving it so that should be really considered technical what's not technical on page 352 is line 14 the house included language say that supplemental payments shall not be made for services provided in wake county additionally if you look further down both of those pages you'll see different percentages over in the senate you see 28.85 over in the house you see 25.9 that's just linked to different approaches to the hospital provider assessment tax these supplemental payments are funded by the university. 05:00