1.1 	A bill for an act
1.2 	relating to medical assistance; requiring medical
1.3 	assistance to cover medication therapy management
1.4 	services; amending Minnesota Statutes 2004, section
1.5 	256B.0625, by adding a subdivision.
1.6 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.7 	Section 1. Minnesota Statutes 2004, section 256B.0625, is
1.8 	amended by adding a subdivision to read:
1.9 		Subd. 13h.Medication therapy management care. (a)
1.10 	Medical assistance covers medication therapy management services
1.11 	for a recipient taking four or more prescriptions to treat or
1.12 	prevent two or more chronic medical conditions, or a recipient
1.13 	with a drug therapy problem that is identified or prior
1.14 	authorized by the commissioner that has resulted or is likely to
1.15 	result in significant nondrug program costs.  For purposes of
1.16 	this subdivision, "medication therapy management" means the
1.17 	provision of the following pharmaceutical care services by a
1.18 	licensed pharmacist to optimize the therapeutic outcomes of the
1.19 	patient's medications:
1.20 	(1) performing or obtaining necessary assessments of the
1.21 	patient's health status;
1.22 	(2) formulating a medication treatment plan;
1.23 	(3) monitoring and evaluating the patient's response to
1.24 	therapy, including safety and effectiveness;
1.25 	(4) performing a comprehensive medication review to
2.1 	identify, resolve, and prevent medication-related problems,
2.2 	including adverse drug events;
2.3 	(5) documenting the care delivered and communicating
2.4 	essential information to the patient's other primary care
2.5 	providers;
2.6 	(6) providing verbal education and training designed to
2.7 	enhance patient understanding and appropriate use of the
2.8 	patient's medications;
2.9 	(7) providing information, support services, and resources
2.10 	designed to enhance patient adherence with the patient's
2.11 	therapeutic regimens; and 
2.12 	(8) coordinating and integrating medication therapy
2.13 	management services within the broader health care management
2.14 	services being provided to the patient.
2.15 	Nothing in this subdivision shall be construed to expand or
2.16 	modify the scope of practice of the pharmacist as defined in
2.17 	section 151.01, subdivision 27.
2.18 	(b) To be eligible for reimbursement for services under
2.19 	this subdivision, a pharmacist must meet the following
2.20 	requirements:
2.21 	(1) have a valid license issued under chapter 151;
2.22 	(2) have graduated from an accredited college of pharmacy
2.23 	on or after May 1996, or completed a structured and
2.24 	comprehensive education program approved by the Board of
2.25 	Pharmacy and the American Council of Pharmaceutical Education
2.26 	for the provision and documentation of pharmaceutical care
2.27 	management services that has both clinical and didactic
2.28 	elements;
2.29 	(3) be practicing in an ambulatory care setting as part of
2.30 	a multidisciplinary team or have developed a structured patient
2.31 	care process that is offered in a private or semiprivate patient
2.32 	care area that is separate from the commercial business that
2.33 	also occurs in the setting; and 
2.34 	(4) make use of an electronic patient record system that
2.35 	meets state standards.
2.36 	(c) For purposes of reimbursement for medication therapy
3.1 	management services, the commissioner may enroll individual
3.2 	pharmacists as medical assistance providers.  The commissioner
3.3 	may also establish contact requirements between the pharmacist
3.4 	and recipient, including limiting the number of reimbursable
3.5 	consultations per recipient.
3.6 	(d) The commissioner, after receiving recommendations from
3.7 	professional medical associations, professional pharmacy
3.8 	associations, and consumer groups, shall convene a nine-member
3.9 	Medication Therapy Management Advisory Committee to advise the
3.10 	commissioner on the implementation and administration of
3.11 	medication therapy management services.  The committee shall be
3.12 	comprised of:  two licensed physicians; two licensed
3.13 	pharmacists; two consumer representatives; and three members
3.14 	with expertise in the area of medication therapy management, who
3.15 	may be licensed physicians or licensed pharmacists.  The
3.16 	committee is governed by section 15.059, except that committee
3.17 	members do not receive compensation or reimbursement for
3.18 	expenses.  The advisory committee expires on June 30, 2007.
3.19 	(e) The commissioner shall evaluate the effect of
3.20 	medication therapy management on quality of care, patient
3.21 	outcomes, and program costs, and shall include a description of
3.22 	any savings generated in the medical assistance program that can
3.23 	be attributable to this coverage.  The evaluation shall be
3.24 	submitted to the legislature by December 15, 2007.  The
3.25 	commissioner may contract with a vendor or an academic
3.26 	institution that has expertise in evaluating health care
3.27 	outcomes for the purpose of completing the evaluation.