SF 14

as introduced - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act 
  1.2             relating to health; providing for a low-cost 
  1.3             prescription drug program; appropriating money; 
  1.4             proposing coding for new law in Minnesota Statutes, 
  1.5             chapter 62J. 
  1.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.7      Section 1.  [62J.6851] [DEFINITIONS.] 
  1.8      Subdivision 1.  [APPLICABILITY.] For purposes of sections 
  1.9   62J.6851 and 62J.6855, the following terms have the meanings 
  1.10  given them. 
  1.11     Subd. 2.  [ELIGIBLE INDIVIDUAL.] "Eligible individual" 
  1.12  means a person who: 
  1.13     (1) meets the residency requirements of section 256L.09; 
  1.14     (2) is not eligible for a program under which federal, 
  1.15  state, or county funds are used to pay part or all of the cost 
  1.16  of the individual's prescription drugs; and 
  1.17     (3) does not have coverage for prescription drugs under a 
  1.18  health plan, as defined in section 62Q.01, subdivision 3. 
  1.19     Subd. 3.  [PRESCRIPTION DRUG MANUFACTURER.] "Prescription 
  1.20  drug manufacturer" means a manufacturer, as defined under 
  1.21  section 151.44, paragraph (c), of a prescription drug, as 
  1.22  defined under section 151.44, paragraph (d). 
  1.23     Sec. 2.  [62J.6853] [LOW-COST PRESCRIPTION DRUG PROGRAM.] 
  1.24     Subdivision 1.  [REBATE AGREEMENT.] A prescription drug 
  1.25  manufacturer that sells prescription drugs in the state through 
  2.1   the medical assistance program shall enter into a rebate 
  2.2   agreement with the commissioner of administration.  The rebate 
  2.3   agreement must require the manufacturer to make rebate payments 
  2.4   to the state each calendar quarter or according to a schedule 
  2.5   established by the commissioner. 
  2.6      Subd. 2.  [REBATE AMOUNT; DISPOSITION.] The rebate amount 
  2.7   required from a prescription drug manufacturer in an agreement 
  2.8   under subdivision 1 is equivalent to the rebate amount 
  2.9   calculated under the federal Medicaid Rebate Program according 
  2.10  to United States Code, title 42, section 1396r-8.  
  2.11  Manufacturers' pricing information is nonpublic data.  The 
  2.12  rebate shall be deposited in the state treasury and credited to 
  2.13  the prescription drug fund. 
  2.14     Subd. 3.  [APPLICATION OF DISCOUNT.] (a) A pharmacy that is 
  2.15  registered under section 151.19 and dispenses prescription drugs 
  2.16  for medical assistance recipients shall charge an eligible 
  2.17  individual a price for a prescription drug that equals the price 
  2.18  paid to the pharmacy to provide the same prescription drug to a 
  2.19  medical assistance recipient according to section 256B.0625, 
  2.20  subdivision 13. 
  2.21     (b) The obligation of a pharmacy to discount a prescription 
  2.22  drug does not begin until three months after the prescription 
  2.23  drug manufacturer begins to pay a rebate under subdivision 1. 
  2.24     Subd. 4.  [PHARMACY REIMBURSEMENT.] (a) The commissioner of 
  2.25  administration shall reimburse a pharmacy the amount of the 
  2.26  discount the pharmacy provides to an eligible individual.  
  2.27  Pharmacies shall submit claims to the commissioner to verify the 
  2.28  amount due for reimbursement.  The commissioner shall reimburse 
  2.29  pharmacies on a monthly basis. 
  2.30     (b) The commissioner of administration may enter into a 
  2.31  contract with a claims processing company to process payments to 
  2.32  pharmacies.  The contract must include quality assurance and 
  2.33  verification procedures and authority to conduct audits of 
  2.34  pharmacy claims as necessary to ensure that pharmacy 
  2.35  reimbursement payments are appropriate and justified.  The 
  2.36  contract may provide for a fixed claims processing fee not to 
  3.1   exceed five cents for each prescription drug provided to 
  3.2   eligible individuals, to be paid by the claiming pharmacy. 
  3.3      Subd. 5.  [PRESCRIPTION DRUG FUND.] The prescription drug 
  3.4   fund is established in the state treasury.  The money in the 
  3.5   fund is appropriated to the commissioner of administration to 
  3.6   reimburse pharmacies according to subdivision 4 and to 
  3.7   administer the low-cost prescription drug program.  The fund 
  3.8   consists of money deposited according to subdivision 2 and money 
  3.9   appropriated by law for purposes of the low-cost prescription 
  3.10  drug program. 
  3.11     Sec. 3.  [62J.6855] [RULEMAKING.] 
  3.12     (a) The commissioner of human services shall adopt rules 
  3.13  concerning: 
  3.14     (1) application for and eligibility and enrollment in the 
  3.15  low-cost prescription drug program; and 
  3.16     (2) a method of identifying qualified individuals to 
  3.17  pharmacies.  
  3.18     (b) The commissioner of administration shall adopt rules 
  3.19  concerning: 
  3.20     (1) claims forms and claims procedures to be used by 
  3.21  pharmacies in seeking reimbursement; 
  3.22     (2) a schedule for drug manufacturers to pay rebates to the 
  3.23  commissioner according to rebate agreements entered into under 
  3.24  section 62J.6853, subdivision 1; 
  3.25     (3) collection of utilization and audit data from 
  3.26  pharmacies; and 
  3.27     (4) resolution of disputes over the amount of rebate due 
  3.28  from a manufacturer. 
  3.29     Sec. 4.  [EFFECTIVE DATE.] 
  3.30     Sections 1 and 2 are effective July 1, 2002.  Section 3 is 
  3.31  effective the day following final enactment.