1.1 	A bill for an act
1.2 	relating to human services; changing and clarifying
1.3 	provisions for prescription drugs under medical
1.4 	assistance; amending Minnesota Statutes 2004, section
1.5 	256B.0625, subdivisions 13f, 13g.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2004, section 256B.0625,
1.8 	subdivision 13f, is amended to read:
1.9 		Subd. 13f.Prior authorization.  (a) The Formulary
1.10 	Committee shall review and recommend drugs which require prior
1.11 	authorization.  The Formulary Committee shall establish general
1.12 	criteria to be used for the prior authorization of brand-name
1.13 	drugs for which generically equivalent drugs are available, but
1.14 	the committee is not required to review each brand-name drug for
1.15 	which a generically equivalent drug is available.
1.16 	(b) Prior authorization may be required by the commissioner
1.17 	before certain formulary drugs are eligible for payment.  The
1.18 	Formulary Committee may recommend drugs for prior authorization
1.19 	directly to the commissioner.  The commissioner may also request
1.20 	that the Formulary Committee review a drug for prior
1.21 	authorization.  Before the commissioner may require prior
1.22 	authorization for a drug:
1.23 	(1) the commissioner must provide information to the
1.24 	Formulary Committee on the impact that placing the drug on prior
1.25 	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. A 30-day
2.9 	notice must be provided for the forum.
2.10 	The commissioner must provide a 15-day 30-day notice period
2.11 	before implementing the prior authorization.
2.12 	(c) Prior authorization shall not be required or utilized
2.13 	for any atypical antipsychotic drug prescribed for the treatment
2.14 	of mental illness if:
2.15 	(1) there is no generically equivalent drug available; and 
2.16 	(2) the drug was initially prescribed for the recipient
2.17 	prior to July 1, 2003; or
2.18 	(3) the drug is part of the recipient's current course of
2.19 	treatment.
2.20 	Nothing in this paragraph requires a person with a mental
2.21 	illness to switch to a generic medication.This paragraph
2.22 	applies to any multistate preferred drug list or supplemental
2.23 	drug rebate program established or administered by the
2.24 	commissioner.
2.25 	(d) Prior authorization shall not be required or utilized
2.26 	for any antihemophilic factor drug prescribed for the treatment
2.27 	of hemophilia and blood disorders where there is no generically
2.28 	equivalent drug available if the prior authorization is used in
2.29 	conjunction with any supplemental drug rebate program or
2.30 	multistate preferred drug list established or administered by
2.31 	the commissioner.  This paragraph expires July 1, 2005.
2.32 	(e) The commissioner may require prior authorization for
2.33 	brand name drugs whenever a generically equivalent product is
2.34 	available, even if the prescriber specifically indicates
2.35 	"dispense as written-brand necessary" on the prescription as
2.36 	required by section 151.21, subdivision 2, except as provided in
3.1 	paragraph (c).

3.2 	Sec. 2. Minnesota Statutes 2004, section 256B.0625,
3.3 	subdivision 13g, is amended to read:
3.4 		Subd. 13g.Preferred drug list.  (a) The commissioner
3.5 	shall adopt and implement a preferred drug list by January 1,
3.6 	2004.  The commissioner may enter into a contract with a vendor
3.7 	or one or more states for the purpose of participating in a
3.8 	multistate preferred drug list and supplemental rebate program.
3.9 	The commissioner shall ensure that any contract meets all
3.10 	federal requirements and maximizes federal financial
3.11 	participation.  The commissioner shall publish the preferred
3.12 	drug list annually in the State Register and shall maintain an
3.13 	accurate and up-to-date list on the agency Web site.
3.14 	(b) The commissioner may add to, delete from, and otherwise
3.15 	modify the preferred drug list, after consulting with the
3.16 	Formulary Committee and appropriate medical specialists and
3.17 	providing public notice and the opportunity for public comment.
3.18 	(c) The commissioner shall adopt and administer the
3.19 	preferred drug list as part of the administration of the
3.20 	supplemental drug rebate program.  Reimbursement for
3.21 	prescription drugs not on the preferred drug list may be subject
3.22 	to prior authorization, unless the drug manufacturer signs a
3.23 	supplemental rebate contract.
3.24 	(d) For purposes of this subdivision, "preferred drug list"
3.25 	means a list of prescription drugs within designated therapeutic
3.26 	classes selected by the commissioner, for which prior
3.27 	authorization based on the identity of the drug or class is not
3.28 	required.
3.29 	(e) The commissioner shall seek any federal waivers or
3.30 	approvals necessary to implement this subdivision.
3.31 	(f) The commissioner shall utilize education and management
3.32 	programs to reduce inefficient and ineffective prescribing
3.33 	patterns for prescription drug treatment of mental illness.  The
3.34 	definition of such patterns will be based on nationally
3.35 	recognized treatment protocols, generally accepted drug
3.36 	utilization review practices, or medication algorithms.  These
4.1 	methods shall be used in lieu of other methods that restrict
4.2 	access to medications solely on the basis of a preferred drug
4.3 	list.