2016 Regular Session ENROLLED
SENATE BILL NO. 117
BY SENATOR MILLS
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 Medicaid 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(B)(2)(a)(iv), the introductory paragraph of (D)(2), (D)(2)(c),
13 (d), (e), (f), (g), (h), (k), and (p), and (D)(5)(b) and (c) are hereby amended and reenacted to
14 read as follows:
15 ยง153.3. Medical vendor reimbursements; allowable restrictions; peer-based
16 prescribing and dispensing practice patterns; Medicaid
17 Pharmaceutical and Therapeutics Committee
18 * * *
19 B.
20 * * *
21 (2)(a)
22 * * *
23 (iv) Involve medical personnel, including but not limited to pharmacists,
24 pharmacy technicians, nurses, and physicians.
25 * * *
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1 D.
2 * * *
3 (2) Each nominating organization shall certify by affidavit that the practice
4 of each nominee involves either the care of or the supervision of the care of no less
5 than one hundred fifty Medicaid recipients. The committee shall be comprised of the
6 following persons:
7 * * *
8 (c) One practicing physician who is participating in the Title XIX program
9 as a family practitioner recommended from a list of three names submitted by the
10 Louisiana State Medical Society.
11 (d) One practicing physician who is participating in the Title XIX program
12 as an internal medicine specialist recommended from a list of three names submitted
13 by the Louisiana State Medical Society.
14 (e) One practicing physician who is participating in the Title XIX program
15 as a pediatrician recommended from a list of three names submitted by the Louisiana
16 State Medical Society.
17 (f) One practicing physician who is participating in the Title XIX program
18 as a surgeon recommended from a list of three names submitted by the Louisiana
19 State Medical Society.
20 (g) One practicing physician who is participating in the Title XIX program
21 as an obstetrics/gynecologist recommended from a list of three names submitted by
22 the Louisiana State Medical Society.
23 (h) Two practicing physicians who are participating in the Title XIX program
24 recommended from a list of six names submitted by the Louisiana Medical
25 Association.
26 * * *
27 (k) Two practicing pharmacists who are participating in the Title XIX drug
28 program recommended from a list of six names submitted by the Louisiana
29 Pharmacists Association. One pharmacist shall be an independent pharmacist
30 recommended by the Louisiana Independent Pharmacies Association and one
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1 pharmacist shall be a pharmacist representing a chain pharmacy recommended by
2 the Louisiana Pharmacists Association.
3 * * *
4 (p) One practicing physician who is participating in the Title XIX program
5 as a psychiatrist recommended from a list of three names submitted by the Louisiana
6 Psychiatric Medical Association.
7 * * *
8 (5)
9 * * *
10 (b) The committee shall be responsible for developing and maintaining a
11 pharmacopoeia preferred drug list established in conjunction with a prior approval
12 process as provided in Subparagraph (B)(2)(a) of this Section. The pharmacopoeia
13 preferred drug list shall comply with all applicable state and federal laws, rules,
14 and regulations. The committee may recommend additions and deletions to the
15 pharmacopoeia preferred drug list and the pharmacopoeia preferred drug list may
16 change in accordance with those recommendations. The committee shall also advise
17 the secretary of the department on policy recommendations related to the prudent
18 administration of the Medicaid drug program. The secretary shall assure that all
19 actions of the committee comply with applicable state and federal laws, rules, and
20 regulations prior to implementation or modification of the pharmacopoeia preferred
21 drug list. The clinical decisions regarding the preferred drug list shall be made
22 transparent through a written report that is publicly available. If the decision of the
23 Medicaid Pharmaceutical and Therapeutics Committee is contrary to the clinical
24 evidence found in labeling, drug compendia, or peer review literature, such decisions
25 shall be justified in writing.
26 (c) Any new drug approved by the United States Food and Drug
27 Administration shall may be added to the formulary preferred drug list as soon as
28 when it becomes commercially available and the manufacturer enters into a
29 federal medicaid drug rebate program if the department determines it is in the
30 best interest of the medical assistance program. The Medicaid Pharmaceutical and
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1 Therapeutics Committee shall conduct an evidence-based analysis of the drug to
2 determine if the drug shall be maintained on the formulary preferred drug list. The
3 analysis shall include but not be limited to the medical evidence of the clinical
4 effectiveness of the drug as well as evidence of the cost-effectiveness of the drug in
5 treating illness and disease. The determination by the committee on any new drug
6 approval by the United States Food and Drug Administration shall be made no later
7 than ninety days after the drug becomes commercially available. Prior to a drug
8 being prior authorized, it must have been reviewed by the Medicaid Pharmaceutical
9 and Therapeutics Committee. When a new drug that is included in the Medicaid
10 Pharmaceutical and Therapeutics Committee process is approved by the United
11 States Food and Drug Administration, the drug shall be reviewed at the next
12 Medicaid Pharmaceutical and Therapeutics Committee meeting.
13 Section 2. R.S. 46:153.3(B)(1)(b), (c), (d), and (e), (B)(2)(d), (B)(3) and (4), (C)(2)
14 and (3), and (D)(5)(d) and (e) are hereby repealed in their entirety.
15 Section 3. This Act shall become effective upon signature by the governor or, if not
16 signed by the governor, upon expiration of the time for bills to become law without signature
17 by the governor, as provided by Article III, Section 18 of the Constitution of Louisiana. If
18 vetoed by the governor and subsequently approved by the legislature, this Act shall become
19 effective on the day following such approval.
PRESIDENT OF THE SENATE
SPEAKER OF THE HOUSE OF REPRESENTATIVES
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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