1-1 By: Maxey, Alvarado (Senate Sponsor - Moncrief) H.B. No. 494 1-2 (In the Senate - Received from the House May 5, 1999; 1-3 May 6, 1999, read first time and referred to Committee on Human 1-4 Services; May 13, 1999, reported favorably by the following vote: 1-5 Yeas 5, Nays 0; May 13, 1999, sent to printer.) 1-6 A BILL TO BE ENTITLED 1-7 AN ACT 1-8 relating to drug benefits available under certain health care 1-9 programs administered by the Texas Department of Health. 1-10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-11 SECTION 1. Subchapter B, Chapter 32, Human Resources Code, 1-12 is amended by adding Section 32.0311 to read as follows: 1-13 Sec. 32.0311. DRUG REIMBURSEMENT UNDER CERTAIN PROGRAMS. 1-14 The department shall require a recipient of medical assistance to 1-15 exhaust drug benefits available under the medical assistance 1-16 program before reimbursing the recipient, pharmacist, or other 1-17 health care provider for drugs purchased by or on behalf of the 1-18 recipient under the Kidney Health Care Program or the Chronically 1-19 Ill and Disabled Children's Services Program. 1-20 SECTION 2. Subchapter B, Chapter 12, Health and Safety Code, 1-21 is amended by adding Section 12.0125 to read as follows: 1-22 Sec. 12.0125. DRUG REBATES. (a) The department shall 1-23 develop a drug manufacturer rebate program for drugs purchased by 1-24 or on behalf of a client of the Kidney Health Care Program or the 1-25 Chronically Ill and Disabled Children's Services Program for which 1-26 rebates are not available under the Medicaid drug manufacturer 1-27 rebate program. 1-28 (b) The department shall consult with drug manufacturers to 1-29 develop rebate amounts for the new rebate program. The average 1-30 percentage savings from rebates in the new program may not be less 1-31 than the average percentage savings from rebates in the Medicaid 1-32 drug manufacturer rebate program. 1-33 (c) Amounts received by the department under the drug rebate 1-34 program established under this section may be appropriated only for 1-35 the Kidney Health Care Program or the Chronically Ill and Disabled 1-36 Children's Services Program. 1-37 SECTION 3. (a) To the extent authorized by federal law, the 1-38 Texas Department of Health shall consolidate with the Medicaid 1-39 Vendor Drug Program the drug benefits components of the Kidney 1-40 Health Care Program and the Chronically Ill and Disabled Children's 1-41 Services Program. 1-42 (b) Except as provided by Subsection (c) of this section, 1-43 the department shall use the following functions and components of 1-44 the Medicaid Vendor Drug Program for the consolidated program: 1-45 (1) claims processing and program monitoring 1-46 procedures; 1-47 (2) prior authorization safeguards; 1-48 (3) dispute resolution procedures and approval 1-49 criteria; 1-50 (4) emergency access procedures; 1-51 (5) pharmacy network; and 1-52 (6) reimbursement rates. 1-53 (c) The department shall develop reimbursement rates for 1-54 drugs purchased by or on behalf of a client of the Kidney Health 1-55 Care Program or the Chronically Ill and Disabled Children's 1-56 Services Program that are not included in the Medicaid Vendor Drug 1-57 Program's list of reimbursable drugs. 1-58 (d) The department shall obtain drug manufacturer rebates 1-59 for drugs purchased by or on behalf of a client of the Kidney 1-60 Health Care Program or the Chronically Ill and Disabled Children's 1-61 Services Program under the Medicaid drug manufacturer rebate 1-62 program and the drug rebate program developed under Section 1-63 12.0125, Health and Safety Code, as added by this Act. 1-64 (e) The department shall update its computer system to 2-1 facilitate the consolidation. 2-2 SECTION 4. (a) Not later than September 1, 1999, the Texas 2-3 Department of Health shall complete the implementation of the drug 2-4 manufacturer rebate program required by Section 12.0125, Health and 2-5 Safety Code, as added by this Act. 2-6 (b) Not later than March 1, 2001, the Texas Department of 2-7 Health shall complete the implementation of the consolidated 2-8 program required by Section 3 of this Act. 2-9 SECTION 5. The importance of this legislation and the 2-10 crowded condition of the calendars in both houses create an 2-11 emergency and an imperative public necessity that the 2-12 constitutional rule requiring bills to be read on three several 2-13 days in each house be suspended, and this rule is hereby suspended, 2-14 and that this Act take effect and be in force from and after its 2-15 passage, and it is so enacted. 2-16 * * * * *