1.1 	A bill for an act
1.2 	relating to human services; removing the sunset for a
1.3 	provision exempting certain antihemophilic factor
1.4 	drugs from prior authorization under medical
1.5 	assistance; amending Minnesota Statutes 2004, section
1.6 	256B.0625, subdivision 13f.
1.7 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.8 	Section 1. Minnesota Statutes 2004, section 256B.0625,
1.9 	subdivision 13f, is amended to read:
1.10 		Subd. 13f.Prior authorization.  (a) The Formulary
1.11 	Committee shall review and recommend drugs which require prior
1.12 	authorization.  The Formulary Committee shall establish general
1.13 	criteria to be used for the prior authorization of brand-name
1.14 	drugs for which generically equivalent drugs are available, but
1.15 	the committee is not required to review each brand-name drug for
1.16 	which a generically equivalent drug is available.
1.17 	(b) Prior authorization may be required by the commissioner
1.18 	before certain formulary drugs are eligible for payment.  The
1.19 	Formulary Committee may recommend drugs for prior authorization
1.20 	directly to the commissioner.  The commissioner may also request
1.21 	that the Formulary Committee review a drug for prior
1.22 	authorization.  Before the commissioner may require prior
1.23 	authorization for a drug:
1.24 	(1) the commissioner must provide information to the
1.25 	Formulary Committee on the impact that placing the drug on prior
1.26 	authorization may have on the quality of patient care and on
2.1 	program costs, information regarding whether the drug is subject
2.2 	to clinical abuse or misuse, and relevant data from the state
2.3 	Medicaid program if such data is available;
2.4 	(2) the Formulary Committee must review the drug, taking
2.5 	into account medical and clinical data and the information
2.6 	provided by the commissioner; and
2.7 	(3) the Formulary Committee must hold a public forum and
2.8 	receive public comment for an additional 15 days.
2.9 	The commissioner must provide a 15-day notice period before
2.10 	implementing the prior authorization.
2.11 	(c) Prior authorization shall not be required or utilized
2.12 	for any atypical antipsychotic drug prescribed for the treatment
2.13 	of mental illness if:
2.14 	(1) there is no generically equivalent drug available; and
2.15 	(2) the drug was initially prescribed for the recipient
2.16 	prior to July 1, 2003; or
2.17 	(3) the drug is part of the recipient's current course of
2.18 	treatment.
2.19 	This paragraph applies to any multistate preferred drug list or
2.20 	supplemental drug rebate program established or administered by
2.21 	the commissioner.
2.22 	(d) Prior authorization shall not be required or utilized
2.23 	for any antihemophilic factor drug prescribed for the treatment
2.24 	of hemophilia and blood disorders where there is no generically
2.25 	equivalent drug available if the prior authorization is used in
2.26 	conjunction with any supplemental drug rebate program or
2.27 	multistate preferred drug list established or administered by
2.28 	the commissioner. This paragraph expires July 1, 2005.
2.29 	(e) The commissioner may require prior authorization for
2.30 	brand name drugs whenever a generically equivalent product is
2.31 	available, even if the prescriber specifically indicates
2.32 	"dispense as written-brand necessary" on the prescription as
2.33 	required by section 151.21, subdivision 2.
2.34 	
EFFECTIVE DATE. This section is effective June 30, 2005.