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A BILL TO BE ENTITLED
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AN ACT
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relating to a study of the feasibility of establishing separate |
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reimbursement under the Medicaid vendor drug program for certain |
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pharmacy care management services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. DEFINITION. In this Act, "pharmacy care |
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management services" means services provided by a pharmacy to |
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support patients receiving treatment or therapy through a specialty |
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pharmacy drug or therapy and maximize adherence to the drug or |
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therapy, including: |
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(1) significant caregiver and provider contact and |
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education regarding the relevant disease, disease prevention and |
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treatment, and counseling related to drug indications, benefits, |
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risks, complications, and appropriate use of the prescribed drug or |
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therapy; |
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(2) patient compliance services, including |
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coordination of provider visits with delivery of the specialty drug |
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or therapy to the provider, compliance with the dosing regimen, |
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patient reminders, compilation of data, and assisting providers in |
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the development of compliance programs; and |
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(3) tracking services, including developing ordering |
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processes with a provider, screening referrals, and tracking a |
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patient's weight for dosing requirements. |
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SECTION 2. STUDY. (a) The Health and Human Services |
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Commission shall study the feasibility of establishing separate |
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reimbursement rates under the Medicaid vendor drug program for |
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pharmacies that provide pharmacy care management services to |
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patients who are administered specialty pharmacy drugs, including |
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drugs indicated for the prophylaxis of respiratory syncytial virus, |
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blood factor, or any other biologic or therapy that requires |
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complex care. |
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(b) In conducting the study under Subsection (a) of this |
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section, the Health and Human Services Commission shall consult |
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with the Centers for Medicare and Medicaid Services and may |
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consider the adoption of pharmacy care management services |
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reimbursement for pharmacy services adopted by other state Medicaid |
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programs. |
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(c) The Health and Human Services Commission shall seek |
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information from specialty pharmacy providers or other sources |
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regarding the costs of providing pharmacy care management services. |
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(d) Not later than September 1, 2010, the Health and Human |
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Services Commission shall submit a written report of the results of |
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the study conducted under Subsection (a) of this section to the |
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legislature. |
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SECTION 3. EFFECTIVE DATE. This Act takes effect |
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immediately if it receives a vote of two-thirds of all the members |
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elected to each house, as provided by Section 39, Article III, Texas |
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Constitution. If this Act does not receive the vote necessary for |
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immediate effect, this Act takes effect September 1, 2009. |