|
|
|
|
AN ACT
|
|
relating to the distribution of a prescription drug and a study of |
|
the feasibility of establishing separate reimbursement under the |
|
Medicaid vendor drug program for certain pharmacy care management |
|
services. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. DEFINITION. In this Act, "pharmacy care |
|
management services" means services provided by a pharmacy to |
|
support patients receiving treatment or therapy through a specialty |
|
pharmacy drug or therapy and maximize adherence to the drug or |
|
therapy, including: |
|
(1) significant caregiver and provider contact and |
|
education regarding the relevant disease, disease prevention and |
|
treatment, and counseling related to drug indications, benefits, |
|
risks, complications, and appropriate use of the prescribed drug or |
|
therapy; |
|
(2) patient compliance services, including |
|
coordination of provider visits with delivery of the specialty drug |
|
or therapy to the provider, compliance with the dosing regimen, |
|
patient reminders, compilation of data, and assisting providers in |
|
the development of compliance programs; and |
|
(3) tracking services, including developing ordering |
|
processes with a provider, screening referrals, and tracking a |
|
patient's weight for dosing requirements. |
|
SECTION 2. STUDY. (a) The Health and Human Services |
|
Commission shall study the feasibility of establishing separate |
|
reimbursement rates under the Medicaid vendor drug program for |
|
pharmacies that provide pharmacy care management services to |
|
patients who are administered specialty pharmacy drugs, including |
|
drugs indicated for the prophylaxis of respiratory syncytial virus, |
|
blood factor, or any other biologic or therapy that requires |
|
complex care. |
|
(b) In conducting the study under Subsection (a) of this |
|
section, the Health and Human Services Commission shall consult |
|
with the Centers for Medicare and Medicaid Services and may |
|
consider the adoption of pharmacy care management services |
|
reimbursement for pharmacy services adopted by other state Medicaid |
|
programs. |
|
(c) The Health and Human Services Commission shall seek |
|
information from specialty pharmacy providers or other sources |
|
regarding the costs of providing pharmacy care management services. |
|
(d) Not later than September 1, 2010, the Health and Human |
|
Services Commission shall submit a written report of the results of |
|
the study conducted under Subsection (a) of this section to the |
|
legislature. |
|
SECTION 3. NORMAL DISTRIBUTION CHANNEL. Subdivision (5), |
|
Section 431.401, Health and Safety Code, is amended to read as |
|
follows: |
|
(5) "Normal distribution channel" means a chain of |
|
custody for a prescription drug, either directly or by drop |
|
shipment, from the manufacturer of the prescription drug, the |
|
manufacturer to the manufacturer's co-licensed product partner, |
|
the manufacturer to the manufacturer's third-party logistics |
|
provider, or the manufacturer to the manufacturer's exclusive |
|
distributor, to: |
|
(A) a pharmacy to: |
|
(i) a patient; or |
|
(ii) another designated person authorized |
|
by law to dispense or administer the drug to a patient; |
|
(B) an authorized distributor of record to: |
|
(i) a pharmacy to a patient; or |
|
(ii) another designated person authorized |
|
by law to dispense or administer the drug to a patient; |
|
(C) an authorized distributor of record to a |
|
wholesale distributor licensed under this chapter to another |
|
designated person authorized by law to administer the drug to a |
|
patient; |
|
(D) an authorized distributor of record to a |
|
pharmacy warehouse to the pharmacy warehouse's intracompany |
|
pharmacy; |
|
(E) [(D)] a pharmacy warehouse to the pharmacy |
|
warehouse's intracompany pharmacy or another designated person |
|
authorized by law to dispense or administer the drug to a patient; |
|
(F) [(E)] a person authorized by law to prescribe |
|
a prescription drug that by law may be administered only under the |
|
supervision of the prescriber; or |
|
(G) [(F)] an authorized distributor of record to |
|
one other authorized distributor of record to a licensed |
|
practitioner for office use. |
|
SECTION 4. EXEMPTION FROM CERTAIN PROVISIONS FOR CERTAIN |
|
WHOLESALE DISTRIBUTORS. Section 431.4031, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 431.4031. EXEMPTION FROM CERTAIN PROVISIONS FOR |
|
CERTAIN WHOLESALE DISTRIBUTORS. (a) A wholesale distributor that |
|
distributes prescription drugs that are medical gases or a |
|
wholesale distributor that is a manufacturer or a third-party |
|
logistics provider on behalf of a manufacturer is exempt from |
|
Sections 431.404(a)(5) and (6), (b), and (c), 431.4045(2), 431.405, |
|
431.407, and 431.408. |
|
(b) A state agency or a political subdivision of this state |
|
that distributes prescription drugs using federal or state funding |
|
to nonprofit health care facilities or local mental health or |
|
mental retardation authorities for distribution to a pharmacy, |
|
practitioner, or patient is exempt from Sections 431.405(b), |
|
431.407, 431.408, 431.412, and 431.413. |
|
(c) The executive commissioner of the Health and Human |
|
Services Commission by rule may exempt specific purchases of |
|
prescription drugs by state agencies and political subdivisions of |
|
this state if the executive commissioner determines that the |
|
requirements of this subchapter would result in a substantial cost |
|
to the state or a political subdivision of the state. |
|
SECTION 5. RULES. As soon as practicable after the |
|
effective date of this Act, the executive commissioner of the |
|
Health and Human Services Commission shall adopt, modify, or repeal |
|
rules as necessary to implement the changes in law made by this Act |
|
to Chapter 431, Health and Safety Code. |
|
SECTION 6. EFFECTIVE DATE. This Act takes effect |
|
immediately if it receives a vote of two-thirds of all the members |
|
elected to each house, as provided by Section 39, Article III, Texas |
|
Constitution. If this Act does not receive the vote necessary for |
|
immediate effect, this Act takes effect September 1, 2009. |
|
|
|
|
|
|
|
|
|
|
______________________________ |
______________________________ |
|
President of the Senate |
Speaker of the House |
|
|
I hereby certify that S.B. No. 1645 passed the Senate on |
|
May 7, 2009, by the following vote: Yeas 31, Nays 0; May 30, 2009, |
|
Senate refused to concur in House amendment and requested |
|
appointment of Conference Committee; May 30, 2009, House granted |
|
request of the Senate; May 31, 2009, Senate adopted Conference |
|
Committee Report by the following vote: Yeas 31, Nays 0. |
|
|
|
|
______________________________ |
|
Secretary of the Senate |
|
|
I hereby certify that S.B. No. 1645 passed the House, with |
|
amendment, on May 27, 2009, by the following vote: Yeas 137, |
|
Nays 11, one present not voting; May 30, 2009, House granted |
|
request of the Senate for appointment of Conference Committee; |
|
May 31, 2009, House adopted Conference Committee Report by the |
|
following vote: Yeas 141, Nays 0, one present not voting. |
|
|
|
|
______________________________ |
|
Chief Clerk of the House |
|
|
|
|
|
Approved: |
|
|
|
______________________________ |
|
Date |
|
|
|
|
|
______________________________ |
|
Governor |