HF 1243

as introduced - 79th Legislature (1995 - 1996) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to health; creating the prescription drug 
  1.3             purchasing authority; establishing a drug purchasing 
  1.4             benefit program for senior citizens; appropriating 
  1.5             money; proposing coding for new law in Minnesota 
  1.6             Statutes, chapter 62Q. 
  1.7   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.8      Section 1.  [62Q.42] [DEFINITIONS.] 
  1.9      Subdivision 1.  [APPLICABILITY.] For purposes of sections 
  1.10  62Q.42 to 62Q.52, the following definitions apply. 
  1.11     Subd. 2.  [BOARD.] "Board" means the board of the 
  1.12  prescription drug purchasing authority. 
  1.13     Subd. 3.  [CONTRACT PRICE.] "Contract price" means the 
  1.14  price of a prescription drug, as established through 
  1.15  negotiations between the multistate pharmaceutical contracting 
  1.16  alliance and drug manufacturers and drug wholesalers. 
  1.17     Subd. 4.  [DISEASE MANAGEMENT.] "Disease management" means 
  1.18  a comprehensive and integrated approach to patient pharmacy care 
  1.19  that achieves optimal clinical outcomes and cost-effective 
  1.20  therapy.  The components of disease management include outcome 
  1.21  monitoring, quality improvement, compliance monitoring, patient 
  1.22  education, practice guidelines, and multidisciplinary education. 
  1.23     Subd. 5.  [ELIGIBLE SENIOR.] "Eligible senior" means a 
  1.24  senior citizen eligible for the senior drug purchasing benefit 
  1.25  program under section 62Q.52, subdivision 3. 
  1.26     Subd. 6.  [MULTISTATE PHARMACEUTICAL CONTRACTING ALLIANCE 
  2.1   OR ALLIANCE.] "Multistate pharmaceutical contracting alliance" 
  2.2   or "alliance" means the alliance established and administered by 
  2.3   the commissioner of administration, under the authority granted 
  2.4   in section 471.59. 
  2.5      Subd. 7.  [PRESCRIPTION DRUG PURCHASING AUTHORITY OR 
  2.6   AUTHORITY.] "Prescription drug purchasing authority" or 
  2.7   "authority" means the public corporation established in section 
  2.8   62Q.44. 
  2.9      Subd. 8.  [SENIOR CITIZEN.] "Senior citizen" means a 
  2.10  resident of Minnesota who is age 65 or older. 
  2.11     Subd. 9.  [SENIOR DRUG PURCHASING BENEFIT PROGRAM.] "Senior 
  2.12  drug purchasing benefit program" means the program established 
  2.13  in section 62Q.52. 
  2.14     Sec. 2.  [62Q.44] [PRESCRIPTION DRUG PURCHASING AUTHORITY.] 
  2.15     Subdivision 1.  [ESTABLISHMENT.] The prescription drug 
  2.16  purchasing authority is a public corporation established to 
  2.17  manage the multistate pharmaceutical contracting alliance and 
  2.18  establish and manage a senior drug benefit purchasing program.  
  2.19  The authority is a state agency but is not subject to chapters 
  2.20  14, 16A, 16B, 43A, and 179A. 
  2.21     Subd. 2.  [BOARD OF DIRECTORS.] The authority is governed 
  2.22  by a six-member board of directors, consisting of: 
  2.23     (1) two public members appointed by the commissioner of 
  2.24  administration, one of whom must represent persons over age 65; 
  2.25     (2) the dean of the University of Minnesota college of 
  2.26  pharmacy or a representative; 
  2.27     (3) the executive director or a director of the 
  2.28  prescription drug purchasing authority; and 
  2.29     (4) the director of the senior drug purchasing benefit 
  2.30  program. 
  2.31     The board shall elect a chair from among its members. 
  2.32     Subd. 3.  [TERMS; COMPENSATION; REMOVAL; VACANCIES.] The 
  2.33  board is governed by section 15.0575. 
  2.34     Subd. 4.  [STAFF.] The managers and staff of the multistate 
  2.35  pharmaceutical contracting alliance shall be transferred to the 
  2.36  prescription drug purchasing authority.  The director of 
  3.1   contract services for the alliance shall serve as the executive 
  3.2   director of the authority, and the directors of clinical support 
  3.3   services and disease base management/seniors benefit services 
  3.4   for the alliance shall serve in similar capacities with the 
  3.5   authority.  These directors may hire other staff.  The directors 
  3.6   and other staff transferred or hired are not state employees but 
  3.7   are covered by section 3.736.  The directors and staff may 
  3.8   participate in the following plans for employees in the 
  3.9   unclassified service; the state retirement plan, the state 
  3.10  deferred compensation plan, and the health insurance and life 
  3.11  insurance plans.  The attorney general shall provide legal 
  3.12  services to the board. 
  3.13     Subd. 5.  [ADVISORY COMMITTEES.] (a) The board shall 
  3.14  establish an advisory committee for the senior drug purchasing 
  3.15  benefit program consisting of representatives of pharmacists, 
  3.16  physicians, senior citizens, pharmaceutical manufacturers and 
  3.17  wholesalers, and academic pharmaceutical researchers, and other 
  3.18  members appointed at the discretion of the board.  The advisory 
  3.19  committee is governed by section 15.059, except that, 
  3.20  notwithstanding section 15.059, subdivision 5, it does not 
  3.21  expire. 
  3.22     (b) The advisory council to the multistate pharmaceutical 
  3.23  contracting alliance shall continue to operate in a similar 
  3.24  capacity under the direction of the board. 
  3.25     Sec. 3.  [62Q.46] [POWERS.] 
  3.26     The authority may: 
  3.27     (1) exercise all power and authority currently exercised by 
  3.28  the commissioner of administration in management of the 
  3.29  multistate pharmaceutical contracting alliance; 
  3.30     (2) accept grants from other sources; 
  3.31     (3) set and collect fees for services and programs; 
  3.32     (4) participate jointly with private persons, firms, 
  3.33  corporations, or organizations, or with public entities, in 
  3.34  appropriate programs or projects, and enter into contracts to 
  3.35  spend money to carry out these programs or projects; 
  3.36     (5) enter into contracts or agreements with a federal or 
  4.1   state agency, individual, business entity, or other 
  4.2   organization; 
  4.3      (6) acquire and dispose of real property or an interest in 
  4.4   real property; 
  4.5      (7) purchase insurance; 
  4.6      (8) spend money appropriated to it for its purposes; and 
  4.7      (9) sue and be sued in the manner and subject to the 
  4.8   limitations of other state agencies. 
  4.9      Sec. 4.  [62Q.48] [DUTIES OF THE BOARD.] 
  4.10     The board shall: 
  4.11     (1) manage the multistate pharmaceutical contracting 
  4.12  alliance; 
  4.13     (2) establish and administer the senior drug purchasing 
  4.14  benefit program, as required under section 62Q.52; 
  4.15     (3) request drug manufacturers and drug wholesalers to 
  4.16  voluntarily extend drug prices negotiated through the multistate 
  4.17  pharmaceutical contracting alliance to seniors participating in 
  4.18  the senior drug purchasing benefit program; 
  4.19     (4) establish a disease management program for all persons 
  4.20  served through the multistate pharmaceutical contracting 
  4.21  alliance and the senior drug purchasing benefit program; and 
  4.22     (5) consult regularly with the advisory committees referred 
  4.23  to in section 62Q.44. 
  4.24     Sec. 5.  [62Q.50] [TRANSFER OF AUTHORITY.] 
  4.25     The authority to administer and manage the multistate 
  4.26  pharmaceutical contracting alliance is transferred from the 
  4.27  commissioner of administration to the board of the prescription 
  4.28  drug purchasing authority.  The provisions of section 15.039 
  4.29  apply to this transfer. 
  4.30     Sec. 6.  [62Q.52] [SENIOR DRUG PURCHASING BENEFIT PROGRAM.] 
  4.31     Subdivision 1.  [ESTABLISHMENT AND ADMINISTRATION.] The 
  4.32  board shall request drug manufacturers and drug wholesalers to 
  4.33  voluntarily extend drug prices negotiated through the multistate 
  4.34  pharmaceutical contracting alliance to eligible seniors 
  4.35  participating in the senior drug purchasing benefit program.  If 
  4.36  the manufacturers and wholesalers voluntarily agree to include 
  5.1   eligible seniors in the multistate pharmaceutical contracting 
  5.2   alliance, the board shall:  
  5.3      (1) establish and administer a senior drug purchasing 
  5.4   benefit program to be operational by July 1, 1996; 
  5.5      (2) negotiate multistate contracting prices for 
  5.6   prescription drugs for eligible seniors; 
  5.7      (3) enroll participating pharmacies into the senior drug 
  5.8   purchasing benefit program; and 
  5.9      (4) determine eligibility for seniors and process 
  5.10  applications for the program.  
  5.11  The board may contract with private sector entities to carry out 
  5.12  the duties assigned in clauses (3) and (4). 
  5.13     Subd. 2.  [PARTICIPATING PHARMACIES.] The board shall 
  5.14  accept as a participating pharmacy any pharmacy that agrees to 
  5.15  comply with the requirements established by the board for 
  5.16  participation in the senior drug purchasing benefit program. 
  5.17     Subd. 3.  [ELIGIBILITY.] Senior citizens are eligible for 
  5.18  the program if: 
  5.19     (1) their household income does not exceed 200 percent of 
  5.20  the federal poverty guidelines; 
  5.21     (2) they are enrolled in Medicare Part A and Part B; 
  5.22     (3) they do not have coverage for prescription drugs under 
  5.23  a health plan, as defined in section 62Q.01, subdivision 3; 
  5.24     (4) they do not have coverage for prescription drugs under 
  5.25  a Medicare supplement plan, as defined in sections 62A.31 to 
  5.26  62A.44, or policies, contracts, or certificates that supplement 
  5.27  Medicare issued by health maintenance organizations or those 
  5.28  policies, contracts, or certificates governed by section 1833 or 
  5.29  1876 of the federal Social Security Act, United States Code, 
  5.30  title 42, section 1395, et seq., as amended; 
  5.31     (5) they are not eligible for the medical assistance, 
  5.32  general assistance medical care, or MinnesotaCare program; and 
  5.33     (6) they have resided in the state for no less than 180 
  5.34  days immediately before application for the program. 
  5.35     Subd. 4.  [PURCHASE OF PRESCRIPTION DRUGS.] Participating 
  5.36  pharmacies shall charge eligible seniors, for each prescription 
  6.1   filled, the contract price of the prescription drug plus a 
  6.2   dispensing fee and an administrative fee in the amounts 
  6.3   established by the board.  The contract price must pass on to 
  6.4   eligible seniors the full discount provided to the board by the 
  6.5   drug manufacturer or drug wholesaler. 
  6.6      Subd. 5.  [PHARMACY REIMBURSEMENT.] The board, using 
  6.7   electronic credit exchange, shall reimburse pharmacies on a 
  6.8   weekly basis for each prescription drug purchased by an eligible 
  6.9   senior.  The reimbursement for each prescription must equal the 
  6.10  difference between the pharmacy's purchase price for the 
  6.11  prescription drug and the contract price for the prescription 
  6.12  drug.  The board may contract with an on-line claims adjudicator 
  6.13  to process pharmacy claims.  The cost for on-line claims 
  6.14  processing may be passed on to participating pharmacies. 
  6.15     Subd. 6.  [ADMINISTRATIVE COSTS.] An administrative fee, to 
  6.16  be determined by the board, may be used by the board for 
  6.17  administrative and contract costs.  This administrative fee 
  6.18  shall be set at a percentage of estimated acquisition cost.  The 
  6.19  revolving fund of the multistate pharmaceutical contracting 
  6.20  alliance shall be transferred to the authority and continue to 
  6.21  be used to cover the cost of operating the multistate 
  6.22  pharmaceutical contracting alliance. 
  6.23     Sec. 7.  [62Q.54] [EVALUATION.] 
  6.24     The commissioner of health, in consultation with the 
  6.25  University of Minnesota school of pharmacy, shall evaluate the 
  6.26  effectiveness of the alliance, senior drug purchasing benefit 
  6.27  program, and disease management program in improving patient 
  6.28  outcomes and containing prescription drug costs and overall 
  6.29  health care costs.  This evaluation may be funded by grants 
  6.30  provided by drug manufacturers, as negotiated with the board of 
  6.31  the prescription drug purchasing authority.  The commissioner 
  6.32  shall present an evaluation report to the legislature by January 
  6.33  1, 2001.  The report must include recommendations on whether the 
  6.34  prescription drug purchasing authority and the programs 
  6.35  administered by the authority should be sunset as provided in 
  6.36  section 9, as well as recommendations for effective 
  7.1   administration of those programs if a sunset is not recommended. 
  7.2      Sec. 8.  [APPROPRIATION.] 
  7.3      $........ is appropriated from the general fund to the 
  7.4   board of the prescription drug purchasing authority for the 
  7.5   fiscal year ending June 30, 1996, to be used for start-up costs 
  7.6   related to implementation of sections 1 to 6.  The board shall 
  7.7   repay this money to the general fund by June 30, 1997. 
  7.8      Sec. 9.  [SUNSET.] 
  7.9      Sections 1 to 7 are repealed effective July 1, 2001.