By: Van de Putte  S.B. No. 1645
         (In the Senate - Filed March 10, 2009; March 20, 2009, read
  first time and referred to Committee on Health and Human Services;
  May 1, 2009, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 9, Nays 0; May 1, 2009, sent
  to printer.)
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 1645 By:  Deuell
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to 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.  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.
 
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