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2016 Regular Session
SENATE BILL NO. 117
BY SENATOR MILLS
MEDICAID. Provides for the Medicaid Pharmaceutical and Therapeutics Committee.
(gov sig)
1 AN ACT
2 To amend and reenact R.S. 46:153.3(B)(2)(a)(iv), the introductory paragraph of (D)(2),
3 (D)(2)(c), (d), (e), (f), (g), (h), (k), and (p), and (D)(5)(b) and (c) and to repeal R.S.
4 46:153.3(B)(1)(b), (c), (d), and (e), (B)(2)(d), (B)(3) and (4), (C)(2) and (3), and
5 (D)(5)(d) and (e), relative to the Medicaid Pharmaceutical and Therapeutics
6 Committee; to remove legislative intent and expired implementation restrictions; to
7 remove references to committees that no longer exist; to remove provisions that have
8 been sunset by subsequent legislation; to change the Pharmaceutical and
9 Therapeutics Committee membership selection criteria; to change terminology; to
10 provide for an effective date; and to provide for related matters.
11 Be it enacted by the Legislature of Louisiana:
12 Section 1. R.S. 46:153.3 is hereby amended and reenacted to read as follows:
13 ยง153.3. Medical vendor reimbursements; allowable restrictions; peer-based
14 prescribing and dispensing practice patterns; Medicaid
15 Pharmaceutical and Therapeutics Committee
16 * * *
17 B.
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 117
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1 * * *
2 (2)(a)
3 * * *
4 (iv) Involve medical personnel, including but not limited to pharmacists,
5 pharmacy technicians, nurses, and physicians.
6 * * *
7 D.
8 * * *
9 (2) Each nominating organization shall certify by affidavit that the practice
10 of each nominee involves either the care of or the supervision of the care of no less
11 than one hundred fifty Medicaid recipients. The committee shall be comprised of the
12 following persons:
13 * * *
14 (c) One practicing physician who is participating in the Title XIX program
15 as a family practitioner recommended from a list of three names submitted by the
16 Louisiana State Medical Society.
17 (d) One practicing physician who is participating in the Title XIX program
18 as an internal medicine specialist recommended from a list of three names submitted
19 by the Louisiana State Medical Society.
20 (e) One practicing physician who is participating in the Title XIX program
21 as a pediatrician recommended from a list of three names submitted by the Louisiana
22 State Medical Society.
23 (f) One practicing physician who is participating in the Title XIX program
24 as a surgeon recommended from a list of three names submitted by the Louisiana
25 State Medical Society.
26 (g) One practicing physician who is participating in the Title XIX program
27 as an obstetrics/gynecologist recommended from a list of three names submitted by
28 the Louisiana State Medical Society.
29 (h) Two practicing physicians who are participating in the Title XIX program
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1 recommended from a list of six names submitted by the Louisiana Medical
2 Association.
3 * * *
4 (k) Two practicing pharmacists who are participating in the Title XIX drug
5 program recommended from a list of six names submitted by the Louisiana
6 Pharmacists Association. One pharmacist shall be an independent pharmacist and
7 one pharmacist shall be a pharmacist representing a chain pharmacy.
8 * * *
9 (p) One practicing physician who is participating in the Title XIX program
10 as a psychiatrist recommended from a list of three names submitted by the Louisiana
11 Psychiatric Medical Association.
12 * * *
13 (5)
14 * * *
15 (b) The committee shall be responsible for developing and maintaining a
16 pharmacopoeia preferred drug list established in conjunction with a prior approval
17 process as provided in Subparagraph (B)(2)(a) of this Section. The pharmacopoeia
18 preferred drug list shall comply with all applicable state and federal laws, rules,
19 and regulations. The committee may recommend additions and deletions to the
20 pharmacopoeia preferred drug list and the pharmacopoeia preferred drug list may
21 change in accordance with those recommendations. The committee shall also advise
22 the secretary of the department on policy recommendations related to the prudent
23 administration of the Medicaid drug program. The secretary shall assure that all
24 actions of the committee comply with applicable state and federal laws, rules, and
25 regulations prior to implementation or modification of the pharmacopoeia preferred
26 drug list. The clinical decisions regarding the preferred drug list shall be made
27 transparent through a written report that is publicly available. If the decision of the
28 Medicaid Pharmaceutical and Therapeutics Committee is contrary to the clinical
29 evidence found in labeling, drug compendia, or peer review literature, such decisions
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1 shall be justified in writing.
2 (c) Any new drug approved by the United States Food and Drug
3 Administration shall may be added to the formulary preferred drug list as soon as
4 when it becomes commercially available and the manufacturer enters into a
5 Federal Medicaid Drug Rebate program if the department determines it is in
6 the best interest of the medical assistance program. The Medicaid Pharmaceutical
7 and Therapeutics Committee shall conduct an evidence-based analysis of the drug
8 to determine if the drug shall be maintained on the formulary preferred drug list.
9 The analysis shall include but not be limited to the medical evidence of the clinical
10 effectiveness of the drug as well as evidence of the cost-effectiveness of the drug in
11 treating illness and disease. The determination by the committee on any new drug
12 approval by the United States Food and Drug Administration shall be made no later
13 than ninety days after the drug becomes commercially available. Prior to a drug
14 being prior authorized, it must have been reviewed by the Medicaid Pharmaceutical
15 and Therapeutics Committee.
16 Section 2. R.S. 46:153.3(B)(1)(b), (c), (d), and (e), (B)(2)(d), (B)(3) and (4), (C)(2)
17 and (3), and (D)(5)(d) and (e) are hereby repealed in their entirety.
18 Section 3. This Act shall become effective upon signature by the governor or, if not
19 signed by the governor, upon expiration of the time for bills to become law without signature
20 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
21 vetoed by the governor and subsequently approved by the legislature, this Act shall become
22 effective on the day following such approval.
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Christine Arbo Peck.
DIGEST
SB 117 Original 2016 Regular Session Mills
Present law includes legislative intent that was added in 2006 after implementation of
Medicare Part D and post-Hurricane Katrina. Proposed law removes present law.
Present law includes a restriction on implementation of provisions of present law for a period
of six months after June 13, 2001. Proposed law removes present law.
Present law includes provisions that were sunset by subsequent law. Proposed law removes
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the provisions that were sunset.
Present law requires membership of the committee to be selected from a list of three names
submitted by each represented organization. Proposed law allows each represented
organization to submit one name as their representative.
Present law refers to the Medicaid pharmacy drug list as a pharmacopia. Proposed law
changes the reference to preferred drug list.
Present law provides that new drugs are available on the pharmacopia as soon as they are
approved by the USDA and commercially available. Proposed law states that new drugs may
be added when approved by the USDA and the manufacturer enters into a Federal Medicaid
Drug Rebate program if the department determines it is in the best interest of the medical
assistance program.
Effective upon signature of the governor or lapse of time for gubernatorial action.
(Amends R.S. 46:153.3(B)(2)(a)(iv), (D)(2)(intro para), (D)(2)(c), (d), (e), (f), (g), (h), (k),
and (p), and (D)(5)(b) and (c); repeals R.S. 46:153.3(B)(1)(b), (c), (d), and (e), (B)(2)(d),
(B)(3) and (4), (C)(2) and (3), and (D)(5)(d) and (e))
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.