S.B. 865 78(R)    BILL ANALYSIS


S.B. 865
By: Van de Putte
State Health Care Expenditures, Select
Committee Report (Unamended)



BACKGROUND AND PURPOSE 

Currently, the Medicaid Vendor Drug Program (VDP) uses a variety of
resources to determine 
pharmaceutical product pricing when it reimburses pharmacists
participating in the VDP. Some 
pharmacists have been adversely impacted because they were not reimbursed
accurately or in a timely manner. A nationally recognized drug pricing
standard information source exists, and is considered to be the industry
standard for unbiased and accurate drug price reporting.  This bill
requires the VDP to consider a nationally recognized, unbiased pricing
standard in determining reimbursement amounts, and to update drug prices
weekly. 


RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the Health and Human Services
Commission, or the 
commissioner or executive director of an agency operating part of the
medical assistance program, as appropriate, in SECTION 1 (Section 32.0462,
Human Resources Code) of this bill. 

ANALYSIS

SECTION 1. Amends Subchapter B, Chapter 32, Human Resources Code, by
adding Section 
32.0462, as follows:

 Sec. 32.0462. VENDOR DRUG PROGRAM; PRICING STANDARD. (a) Requires the
Health and Human Services Commission or an agency operating part of the
medical assistance program to consider a nationally recognized, unbiased
pricing standard for prescription drugs in determining reimbursement
amounts under the vendor drug program, and update reimbursement amounts at
least weekly. 

  (b) Requires the Health and Human Services Commission or the
commissioner or 
  executive director of an agency operating part of the medical assistance
program 
(commissioner) to adopt rules implementing this section. Requires the
commissioner, in adopting rules, to ensure that implementation of this
section does not adversely affect the amount of federal funds available to
the state for providing benefits under the vendor drug program. 

SECTION 2. Requires a state agency, if before implementing any provision
of this Act the agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision, to
request the waiver or authorization, and authorizes the agency to delay
implementing that provision until the waiver or authorization is granted. 

SECTION 3. Effective date: September 1, 2003.


EFFECTIVE DATE

This act takes effect September 1, 2003.