1-1 By: Gray, et al. (Senate Sponsor - Moncrief) H.B. No. 1094 1-2 (In the Senate - Received from the House April 27, 2001; 1-3 April 30, 2001, read first time and referred to Committee on Health 1-4 and Human Services; May 7, 2001, reported adversely, with favorable 1-5 Committee Substitute by the following vote: Yeas 6, Nays 0; 1-6 May 7, 2001, sent to printer.) 1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 1094 By: Sibley 1-8 A BILL TO BE ENTITLED 1-9 AN ACT 1-10 relating to the creation of a state prescription drug program for 1-11 certain Medicare beneficiaries. 1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-13 SECTION 1. Chapter 531, Government Code, is amended by adding 1-14 Subchapter I to read as follows: 1-15 SUBCHAPTER I. STATE PRESCRIPTION DRUG PROGRAM 1-16 Sec. 531.301. DEVELOPMENT AND IMPLEMENTATION OF STATE 1-17 PROGRAM; FUNDING. (a) The commission shall develop and implement a 1-18 state prescription drug program that operates in the same manner as 1-19 the vendor drug program operates in providing prescription drug 1-20 benefits to recipients of medical assistance under Chapter 32, 1-21 Human Resources Code. 1-22 (b) A person is eligible for prescription drug benefits 1-23 under the state program if the person is: 1-24 (1) a qualified Medicare beneficiary, as defined by 42 1-25 U.S.C. Section 1396d(p)(1), as amended; 1-26 (2) a specified low-income Medicare beneficiary who is 1-27 eligible for medical assistance for Medicare cost-sharing payments 1-28 under 42 U.S.C. Section 1396a(a)(10)(E)(iii), as amended; 1-29 (3) a qualified disabled and working individual, as 1-30 defined by 42 U.S.C. Section 1396d(s), as amended; 1-31 (4) a qualifying individual who is eligible for that 1-32 assistance under 42 U.S.C. Section 1396a(a)(10)(E)(iv)(I), as 1-33 amended; or 1-34 (5) a qualifying individual who is eligible for that 1-35 assistance under 42 U.S.C. Section 1396a(a)(10)(E)(iv)(II), as 1-36 amended. 1-37 (c) Prescription drugs under the state program may be funded 1-38 only with state money, unless funds are available under federal law 1-39 to fund all or part of the program. 1-40 Sec. 531.302. RULES. (a) The commission shall adopt all 1-41 rules necessary for implementation of the state prescription drug 1-42 program. 1-43 (b) In adopting rules for the state prescription drug 1-44 program, the commission may: 1-45 (1) require a person who is eligible for prescription 1-46 drug benefits to pay a cost-sharing payment; and 1-47 (2) establish a drug utilization review program to 1-48 ensure the appropriate use of prescription drugs under the state 1-49 program. 1-50 Sec. 531.303. GENERIC EQUIVALENT AUTHORIZED. In adopting 1-51 rules under the state program, the commission may require that, 1-52 unless the practitioner's signature on a prescription clearly 1-53 indicates that the prescription must be dispensed as written, the 1-54 pharmacist may select a generic equivalent of the prescribed drug. 1-55 Sec. 531.304. PROGRAM FUNDING PRIORITIES. If money available 1-56 for the state prescription drug program is insufficient to provide 1-57 prescription drug benefits to all persons who are eligible under 1-58 Section 531.301(b), the commission shall limit the number of 1-59 enrollees based on available funding and shall provide the 1-60 prescription drug benefits to eligible persons in the following 1-61 order of priority: 1-62 (1) persons eligible under Section 531.301(b)(1); 1-63 (2) persons eligible under Section 531.301(b)(2); and 1-64 (3) persons eligible under Sections 531.301(b)(3), 2-1 (4), and (5). 2-2 SECTION 2. Not later than January 1, 2002, the Health and 2-3 Human Services Commission shall develop and implement the state 2-4 prescription drug program under Subchapter I, Chapter 531, 2-5 Government Code, as added by this Act. 2-6 SECTION 3. This Act takes effect September 1, 2001. 2-7 * * * * *