SF 3605

as introduced - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; establishing the Minnesota pharmacy access
program; appropriating money; proposing coding for new law in Minnesota
Statutes, chapter 256.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

PHARMACY ACCESS PROGRAM

Section 1.

new text begin [256.9545] MINNESOTA PHARMACY ACCESS PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Establishment; administration. new text end

new text begin The commissioner shall establish
and administer the Minnesota pharmacy access program, effective July 1, 2007.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner's authority. new text end

new text begin The commissioner shall administer a
pharmacy access program for low-income Minnesotans who lack drug coverage. The
commissioner shall seek a rebate agreement from all manufacturers of covered drugs as
defined in section 256B.0625, subdivision 13. For each drug, the amount of the rebate
shall be equal to the rebate as defined for purposes of the federal rebate program in United
States Code, title 42, section 1396r-8. The rebate program shall utilize the terms and
conditions used for the federal rebate program established according to section 1927 of
title XIX of the federal Social Security Act.
new text end

new text begin Subd. 3. new text end

new text begin Definitions. new text end

new text begin For the purpose of this section, the following terms have
the meanings given them.
new text end

new text begin (a) "Commissioner" means the commissioner of human services.
new text end

new text begin (b) "Covered prescription drug" means a prescription drug as defined in section
151.44, paragraph (d), that is:
new text end

new text begin (1) covered under medical assistance as described in section 256B.0625, subdivision
13;
new text end

new text begin (2) provided through a participating pharmacy; and
new text end

new text begin (3) provided by a manufacturer that has a fully executed rebate agreement with the
commissioner under this section and complies with that agreement.
new text end

new text begin (c) "Enrolled individual" means a person who is eligible for the program under
subdivision 4 and has enrolled in the program according to subdivision 5.
new text end

new text begin (d) "Health carrier" means an insurance company licensed under chapter 60A to
offer, sell, or issue an individual or group policy of accident and sickness insurance as
defined in section 62A.01; a nonprofit health service plan corporation operating under
chapter 62C; a health maintenance organization operating under chapter 62D; a joint
self-insurance employee health plan operating under chapter 62H; a community integrated
service network licensed under chapter 62N; a fraternal benefit society operating under
chapter 64B; a city, county, school district, or other political subdivision providing
self-insured health coverage under section 471.617 or sections 471.98 to 471.982; and a
self-funded health plan under United States Code, title 29, section 1169(a), the Employee
Retirement Income Security Act of 1974, as amended.
new text end

new text begin (e) "Individual or family gross income" means income calculated under chapter
256L.
new text end

new text begin (f) "Participating manufacturer" means a manufacturer as defined in section 151.44,
paragraph (c), that agrees to participate in the Minnesota pharmacy access program.
new text end

new text begin (g) "Participating pharmacy" means a pharmacy as defined in section 151.01,
subdivision 2, that agrees to participate in the Minnesota pharmacy access program.
new text end

new text begin Subd. 4. new text end

new text begin Eligible persons. new text end

new text begin To be eligible for the program, an applicant must:
new text end

new text begin (1) be a permanent resident of Minnesota as defined in section 256L.09, subdivision
4;
new text end

new text begin (2) not be entitled to Medicare or enrolled in Medicare, medical assistance, general
assistance medical care, or MinnesotaCare;
new text end

new text begin (3) not be enrolled in and have currently available prescription drug coverage under
a health plan offered by a health carrier or employer or under a pharmacy benefit program
offered by a pharmaceutical manufacturer;
new text end

new text begin (4) meet the citizenship requirements of section 256L.04, subdivision 10; and
new text end

new text begin (5) have individual or family gross income equal to or less than 300 percent of the
federal poverty guidelines. The commissioner shall adjust the income limit each July 1 by
the annual update of the federal poverty guidelines following publication by the United
States Department of Health and Human Services.
new text end

new text begin Subd. 5. new text end

new text begin Social Security number. new text end

new text begin (a) Individuals applying for the Minnesota
pharmacy access program must provide a Social Security number.
new text end

new text begin (b) The commissioner shall not deny eligibility to an otherwise eligible applicant
who has applied for a Social Security number and is awaiting issuance of that Social
Security number.
new text end

new text begin (c) Individuals who refuse to provide a Social Security number because of
well-established religious objections are exempt from the requirements of this subdivision.
The term "well-established religious objections" has the meaning given in Code of Federal
Regulations, title 42, section 435.910.
new text end

new text begin Subd. 6. new text end

new text begin Application procedure. new text end

new text begin (a) Applications and information on the program
must be made available at county social services agencies, health care provider offices,
and agencies and organizations serving people with disabilities. Individuals shall submit
applications and any information specified by the commissioner as being necessary to
verify eligibility directly to the commissioner. The commissioner shall determine an
applicant's eligibility for the program within 30 days from the date the application is
received.
new text end

new text begin (b) An enrollee's eligibility must be renewed every 12 months with the 12-month
period beginning the month after the application is approved.
new text end

new text begin Subd. 7. new text end

new text begin Participating pharmacy. new text end

new text begin According to a valid prescription, a participating
pharmacy must sell a covered prescription drug to an enrolled individual at the Medicaid
rate, minus an amount that is equal to the rebate amount described in subdivision 9. Each
participating pharmacy shall provide the commissioner with all information necessary to
administer the program, including, but not limited to, information on prescription drug
sales to enrolled individuals and usual and customary retail prices.
new text end

new text begin Subd. 8. new text end

new text begin Notification of rebate amount. new text end

new text begin The commissioner shall notify each
drug manufacturer, each calendar quarter or according to a schedule to be established by
the commissioner, of the amount of the rebate owed on the prescription drugs sold by
participating pharmacies to enrolled individuals.
new text end

new text begin Subd. 9. new text end

new text begin Provision of rebate. new text end

new text begin To the extent that a participating manufacturer's
prescription drugs are prescribed to a resident of this state, the manufacturer must
provide a rebate equal to the rebate provided under the medical assistance program for
any prescription drug distributed by the manufacturer that is purchased by an enrolled
individual at a participating pharmacy. The manufacturer must provide full payment by the
end of the quarter following the quarter of submission of the state invoice for the rebate,
or according to a schedule to be established by the commissioner. The commissioner
shall deposit all rebates received into the Minnesota prescription drug dedicated fund
established under subdivision 11. The manufacturer must provide the commissioner with
any information necessary to verify the rebate determined per drug.
new text end

new text begin Subd. 10. new text end

new text begin Payment to pharmacies. new text end

new text begin The commissioner shall distribute on a
biweekly basis an amount that is equal to an amount anticipated to be collected under
subdivision 9 to each participating pharmacy based on the prescription drugs sold by that
pharmacy to enrolled individuals.
new text end

new text begin Subd. 11. new text end

new text begin Minnesota pharmacy access account. new text end

new text begin (a) The Minnesota pharmacy
access account is established as an account in the State Treasury. The commissioner of
finance shall dedicate all rebates paid under subdivision 9, any federal funds received for
the program, and any appropriations or allocations designated for the program. A sum
sufficient to make the payments required under subdivision 10 is annually appropriated
from the pharmacy access account to the commissioner of human services for the purpose
of funding subdivision 10.
new text end

new text begin The commissioner must administer the program so that the costs total no more than
funds appropriated plus the drug rebate proceeds.
new text end

ARTICLE 2

APPROPRIATIONS

Section 1. new text begin HUMAN SERVICES APPROPRIATIONS.
new text end

new text begin The sums shown in the columns marked "APPROPRIATIONS" are appropriated
from the general fund, or another named fund, to the agencies and for the purposes
specified in this act, to be available for the fiscal year indicated for each purpose, and are
added to the appropriations in Laws 2005, chapter 4, article 9. The figures "2006" and
"2007" where used in this article, mean that the appropriation or appropriations listed
under them are available for the fiscal year ending June 30, 2006, or June 30, 2007,
respectively. The first year is fiscal year 2006. The second year is fiscal year 2007. The
biennium is fiscal years 2006 and 2007.
new text end

new text begin Summary by Fund new text end
	new text begin 2006 new text end	new text begin 2007 new text end
new text begin Health Care Access Fund new text end	new text begin 500,000 new text end	new text begin 1,913,000 new text end

Sec. 2. new text begin PRESCRIPTION DRUG PROGRAM new text end

new text begin Health Care Access new text end

new text begin TRANSFER TO THE MINNESOTA
PHARMACY ACCESS ACCOUNT.
Notwithstanding Minnesota Statutes, section
295.581, the commissioner of finance shall
transfer $1,576,000 from the health care
access fund to the Minnesota pharmacy
access account in fiscal year 2008, $990,000
in fiscal year 2009. Notwithstanding any
section to the contrary, this section shall
sunset June 30, 2009.
new text end

Sec. 3. new text begin HEALTH CARE ADMINISTRATION new text end

new text begin Health Care Access new text end

new text begin -0- new text end

new text begin 469,000 new text end

new text begin HEALTH CARE ACCESS FUND
APPROPRIATIONS. Of the amount
appropriated for fiscal year 2007, $190,000
is for administration of the Minnesota
pharmacy access program and $279,000 is
for Medicare Part D implementation.
new text end

new text begin HEALTH CARE ADMINISTRATION
BASE LEVEL ADJUSTMENT. The
health care access fund base for health care
administration is decreased by $33,000 in
fiscal year 2008 and $33,000 in fiscal year
2009 for Medicare Part D enrollment and
access activities.
new text end

new text begin HEALTH CARE ADMINISTRATION
BASE LEVEL ADJUSTMENT. The
health care access fund base for health care
administration is increased by $280,000 in
fiscal year 2008 and $280,000 in fiscal year
2009 for administrative activities associated
with the Minnesota pharmacy access fund.
new text end

Sec. 4. new text begin HEALTH CARE OPERATIONS new text end

new text begin Health Care Access new text end

new text begin HEALTH CARE OPERATIONS BASE
LEVEL ADJUSTMENT. The health
care access fund base for health care
administration is decreased by $86,000 in
fiscal year 2008 and $86,000 in fiscal year
2009.
new text end

Sec. 5. new text begin AGING AND ADULT SERVICES GRANTS new text end

new text begin Health Care Access new text end

new text begin 500,000 new text end

new text begin 1,250,000 new text end

new text begin AGING AND ADULT SERVICES
GRANTS FOR MEDICARE PART D
ASSISTANCE. $500,000 in fiscal year
2006 and $1,250,000 in fiscal year 2007 is
appropriated to the commissioner of human
services for grants awarded through the
Minnesota Board on Aging to Minnesota
Association of Area Agencies on Aging
to provide information and enrollment
assistance for the Medicare Part D program.
new text end

new text begin AGING AND ADULT SERVICES
GRANTS BASE LEVEL ADJUSTMENT.
The health care access fund base for aging
and adult services grants is decreased by
$100,000 in fiscal year 2008 and $100,000
in fiscal year 2009 for information and
assistance grants to Minnesota Association
of Area Agencies on Aging for assisting with
Medicare Part D.
new text end

Sec. 6. new text begin CONTINUING CARE MANAGEMENT new text end

new text begin Health Care Access Fund new text end

new text begin -0- new text end

new text begin 108,000 new text end

new text begin CONTINUING CARE MANAGEMENT
BASE LEVEL ADJUSTMENT. The health
care access fund base for continuing care
management is decreased by $10,000 in fiscal
year 2008 and $10,000 in fiscal year 2009 to
reflect decreased administrative funding for
information and assistance activities.
new text end