HF 979

1st Engrossment - 84th Legislature (2005 - 2006) Posted on 12/15/2009 12:00am

A bill for an act
relating to medical assistance; requiring medical
assistance to cover medication therapy management
services; amending Minnesota Statutes 2004, section
256B.0625, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2004, section 256B.0625, is
amended by adding a subdivision to read:

new text begin Subd. 13h. new text end

new text begin Medication therapy management care. new text end

new text begin (a)
Medical assistance covers medication therapy management services
for a recipient taking four or more prescriptions to treat or
prevent two or more chronic medical conditions, or a recipient
with a drug therapy problem that is identified or prior
authorized by the commissioner that has resulted or is likely to
result in significant nondrug program costs. For purposes of
this subdivision, "medication therapy management" means the
provision of the following pharmaceutical care services by a
licensed pharmacist to optimize the therapeutic outcomes of the
patient's medications:
new text end

new text begin (1) performing or obtaining necessary assessments of the
patient's health status;
new text end

new text begin (2) formulating a medication treatment plan;
new text end

new text begin (3) monitoring and evaluating the patient's response to
therapy, including safety and effectiveness;
new text end

new text begin (4) performing a comprehensive medication review to
identify, resolve, and prevent medication-related problems,
including adverse drug events;
new text end

new text begin (5) documenting the care delivered and communicating
essential information to the patient's other primary care
providers;
new text end

new text begin (6) providing verbal education and training designed to
enhance patient understanding and appropriate use of the
patient's medications;
new text end

new text begin (7) providing information, support services, and resources
designed to enhance patient adherence with the patient's
therapeutic regimens; and
new text end

new text begin (8) coordinating and integrating medication therapy
management services within the broader health care management
services being provided to the patient.
new text end

new text begin Nothing in this subdivision shall be construed to expand or
modify the scope of practice of the pharmacist as defined in
section 151.01, subdivision 27.
new text end

new text begin (b) To be eligible for reimbursement for services under
this subdivision, a pharmacist must meet the following
requirements:
new text end

new text begin (1) have a valid license issued under chapter 151;
new text end

new text begin (2) have graduated from an accredited college of pharmacy
on or after May 1996, or completed a structured and
comprehensive education program approved by the Board of
Pharmacy and the American Council of Pharmaceutical Education
for the provision and documentation of pharmaceutical care
management services that has both clinical and didactic
elements;
new text end

new text begin (3) be practicing in an ambulatory care setting as part of
a multidisciplinary team or have developed a structured patient
care process that is offered in a private or semiprivate patient
care area that is separate from the commercial business that
also occurs in the setting; and
new text end

new text begin (4) make use of an electronic patient record system that
meets state standards.
new text end

new text begin (c) For purposes of reimbursement for medication therapy
management services, the commissioner may enroll individual
pharmacists as medical assistance providers. The commissioner
may also establish contact requirements between the pharmacist
and recipient, including limiting the number of reimbursable
consultations per recipient.
new text end

new text begin (d) The commissioner, after receiving recommendations from
professional medical associations, professional pharmacy
associations, and consumer groups, shall convene a nine-member
Medication Therapy Management Advisory Committee to advise the
commissioner on the implementation and administration of
medication therapy management services. The committee shall be
comprised of: two licensed physicians; two licensed
pharmacists; two consumer representatives; and three members
with expertise in the area of medication therapy management, who
may be licensed physicians or licensed pharmacists. The
committee is governed by section 15.059, except that committee
members do not receive compensation or reimbursement for
expenses. The advisory committee expires on June 30, 2007.
new text end

new text begin (e) The commissioner shall evaluate the effect of
medication therapy management on quality of care, patient
outcomes, and program costs, and shall include a description of
any savings generated in the medical assistance program that can
be attributable to this coverage. The evaluation shall be
submitted to the legislature by December 15, 2007. The
commissioner may contract with a vendor or an academic
institution that has expertise in evaluating health care
outcomes for the purpose of completing the evaluation.
new text end