Minnesota Legislature
HF 987
as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:43am
Current Version - as introduced
1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 2.1 2.2 2.3 2.4 2.5 2.6
2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25
A bill for an act
relating to human services; modifying medical assistance drug formulary
committee provisions; amending Minnesota Statutes 2008, section 256B.0625,
subdivisions 13c, 13f.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2008, section 256B.0625, subdivision 13c, is amended to
read:
Subd. 13c.
Formulary committee.
The commissionerdeleted text begin ,deleted text end new text begin shall provide a notice of
vacancies and post an application for appointment to the formulary committee on the
department's Web site. new text end After new text begin reviewing the applications and new text end receiving deleted text begin recommendationsdeleted text end
new text begin input new text end from professional medical associations deleted text begin anddeleted text end new text begin ,new text end professional pharmacy associations, and
consumer groupsnew text begin , the commissionernew text end shall designate a formulary committee to carry out
duties as described in subdivisions 13 to 13g. The formulary committee shall be comprised
of four licensed physicians actively engaged in the practice of medicine in Minnesotanew text begin ,new text end one
of whom must be actively engaged in the treatment of persons with mental illness; at least
three licensed pharmacists actively engaged in the practice of pharmacy in Minnesota;
new text begin a clinical researcher; new text end and deleted text begin onedeleted text end new text begin three new text end consumer deleted text begin representativedeleted text end new text begin representativesnew text end ; the remainder
to be made up of health care new text begin or mental health care new text end professionals who are licensed in their
field and have recognized knowledge in the clinically appropriate prescribing, dispensing,
and monitoring of covered outpatient drugs. Members of the formulary committee shall
not be employed by the Department of Human Services, but the committee shall be staffed
by an employee of the department who shall serve as an ex officio, nonvoting member
of the committee. The department's medical director shall also serve as an ex officio,
nonvoting member for the committee. Committee members shall serve three-year terms
and may be reappointed new text begin once new text end by the commissionernew text begin for a total of two consecutive termsnew text end .
The formulary committee shall meet at least quarterly. The commissioner may require
more frequent formulary committee meetings as needed. new text begin Meeting notices and drugs to be
considered shall be conspicuously posted on the department's Web site at least 14 days
prior to a meeting. new text end An honorarium of $100 per meeting and reimbursement for mileage
shall be paid to each committee member in attendance.
Sec. 2.
Minnesota Statutes 2008, section 256B.0625, subdivision 13f, is amended to
read:
Subd. 13f.
Prior authorization.
(a) The formulary committee shall review and
recommend drugs which require prior authorization. The formulary committee shall
establish general criteria to be used for the prior authorization of brand-name drugs for
which generically equivalent drugs are available, but the committee is not required to
review each brand-name drug for which a generically equivalent drug is available.
(b) Prior authorization may be required by the commissioner before certain
formulary drugs are eligible for payment. The formulary committee may recommend
drugs for prior authorization directly to the commissioner. The commissioner may also
request that the formulary committee review a drug for prior authorization. Before the
commissioner may require prior authorization for a drug:
(1) the commissioner must provide information to the formulary committee on the
impact that placing the drug on prior authorization may have on the quality of patient care
and on program costs, information regarding whether the drug is subject to clinical abuse
or misuse, and relevant data from the state Medicaid program if such data is available;
(2) the formulary committee must review the drug, taking into account medical and
clinical data and the information provided by the commissionernew text begin or other sourcesnew text end ; and
(3) the formulary committee must hold a public forum and receive public comment
for an additional 15 days.new text begin Notice of the forum must be published in the State Register.
new text end
The commissioner must provide a 15-day notice period before implementing the prior
authorization.
(c) Prior authorization shall not be required or utilized for any atypical antipsychotic
drug prescribed for the treatment of mental illness deleted text begin if:deleted text end new text begin .
new text end
new text begin
(d) Prior authorization shall not be required or utilized for any other medication used
to treat mental illness if:
new text end
(1) there is no generically equivalent drug available; deleted text begin and
deleted text end
(2) the drug deleted text begin was initially prescribed for the recipient prior to July 1, 2003deleted text end new text begin provides a
new method of delivery, longevity, or dosagenew text end ; or
(3) the drug is part of the recipient's current course of treatment.
This paragraph applies to any multistate preferred drug list or supplemental drug rebate
program established or administered by the commissioner. Prior authorization shall
automatically be granted for 60 days for brand name drugs prescribed for treatment of
mental illness within 60 days of when a generically equivalent drug becomes available,
provided that the brand name drug was part of the recipient's course of treatment at the
time the generically equivalent drug became available.
deleted text begin (d)deleted text end new text begin (e) new text end Prior authorization shall not be required or utilized for any antihemophilic
factor drug prescribed for the treatment of hemophilia and blood disorders where there is
no generically equivalent drug available if the prior authorization is used in conjunction
with any supplemental drug rebate program or multistate preferred drug list established or
administered by the commissioner.
deleted text begin (e)deleted text end new text begin (f) new text end The commissioner may require prior authorization for brand name drugs
whenever a generically equivalent product is available, even if the prescriber specifically
indicates "dispense as written-brand necessary" on the prescription as required by section
151.21, subdivision 2.
deleted text begin (f)deleted text end new text begin (g) new text end Notwithstanding this subdivision, the commissioner may automatically
require prior authorization, for a period not to exceed 180 days, for any drug that is
approved by the United States Food and Drug Administration on or after July 1, 2005.
The 180-day period begins no later than the first day that a drug is available for shipment
to pharmacies within the state. The formulary committee shall recommend to the
commissioner general criteria to be used for the prior authorization of the drugs, but
the committee is not required to review each individual drug. In order to continue prior
authorizations for a drug after the 180-day period has expired, the commissioner must
follow the provisions of this subdivision.