Texas 2009 - 81st Regular

Texas Senate Bill SB1536 Compare Versions

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1	1	By: Uresti S.B. No. 1536
2	2	(In the Senate - Filed March 9, 2009; March 17, 2009, read
3	3	first time and referred to Committee on Health and Human Services;
4	4	May 5, 2009, reported adversely, with favorable Committee
5	5	Substitute by the following vote: Yeas 9, Nays 0; May 5, 2009, sent
6	6	to printer.)
7	7	COMMITTEE SUBSTITUTE FOR S.B. No. 1536 By: Uresti
8	8
9	9
10	10	A BILL TO BE ENTITLED
11	11	AN ACT
12	12	relating to preferred drug lists adopted by the Health and Human
13	13	Services Commission and associated requirements regarding
14	14	supplemental rebates, prior authorization, and public
15	15	notification.
16	16	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
17	17	SECTION 1. Section 531.071, Government Code, is amended by
18	18	amending Subsection (c) and adding Subsection (d) to read as
19	19	follows:
20	20	(c) General information about the aggregate costs of
21	21	different classes of drugs is not confidential under Subsection
22	22	(a), except that a drug name or information that could reveal a drug
23	23	name is confidential.
24	24	(d) Information about whether the commission and a
25	25	manufacturer or labeler reached or did not reach a supplemental
26	26	rebate agreement under Section 531.070 for a particular drug is not
27	27	confidential under Subsection (a).
28	28	SECTION 2. Section 531.072, Government Code, is amended by
29	29	adding Subsections (b-1), (b-2), and (c-1) to read as follows:
30	30	(b-1) Notwithstanding Subsection (b), the preferred drug
31	31	lists may contain:
32	32	(1) a drug provided by a manufacturer or labeler that
33	33	has not reached a supplemental rebate agreement with the commission
34	34	if the commission determines that inclusion of the drug on the
35	35	preferred drug lists will have no negative cost impact to the state;
36	36	or
37	37	(2) a drug provided by a manufacturer or labeler that
38	38	has reached an agreement with the commission to provide program
39	39	benefits in lieu of supplemental rebates, as described by Section
40	40	531.070.
41	41	(b-2) Consideration must be given to including all
42	42	strengths and dosage forms of a drug on the preferred drug lists.
43	43	(c-1) In addition to the considerations listed under
44	44	Subsection (c), the commission shall consider the inclusion of
45	45	multiple methods of delivery within each drug class, including
46	46	liquid, tablet, capsule, and orally disintegrating tablets.
47	47	SECTION 3. Section 531.073, Government Code, is amended by
48	48	adding Subsections (g) and (h) to read as follows:
49	49	(g) The commission shall ensure that requests for prior
50	50	authorization may be submitted by telephone, facsimile, or
51	51	electronic communications through the Internet.
52	52	(h) The commission shall provide an automated process that
53	53	may be used to assess a Medicaid recipient's medical and drug claim
54	54	history to determine whether the recipient's medical condition
55	55	satisfies the applicable criteria for dispensing a drug without an
56	56	additional prior authorization request.
57	57	SECTION 4. Section 531.074, Government Code, is amended by
58	58	amending Subsections (i) and (m) and adding Subsections (f-1) and
59	59	(i-1) to read as follows:
60	60	(f-1) The committee shall meet in public and shall permit
61	61	public comment before voting on any changes in the preferred drug
62	62	lists. Minutes of each meeting shall be made available to the
63	63	public not later than the 10th business day after the date the
64	64	minutes are approved. The committee may meet in executive session
65	65	to discuss confidential information as described by Subsection (i).
66	66	(i) The commission shall adopt rules governing the
67	67	operation of the committee, including rules governing the
68	68	procedures used by the committee for providing notice of a meeting
69	69	and rules prohibiting the committee from discussing confidential
70	70	information described by Section 531.071 in a public meeting. The
71	71	committee shall comply with the rules adopted under this subsection
72	72	and Subsection (i-1).
73	73	(i-1) In addition to the rules under Subsection (i), the
74	74	commission by rule shall require the committee or the committee's
75	75	designee to present a summary of any clinical efficacy and safety
76	76	information or analyses regarding a drug under consideration for a
77	77	preferred drug list that is provided to the committee by a private
78	78	entity that has contracted with the commission to provide the
79	79	information. The committee or the committee's designee shall
80	80	provide the summary in electronic form before the public meeting at
81	81	which consideration of the drug occurs. Confidential information
82	82	described by Section 531.071 must be omitted from the summary. The
83	83	summary must be posted on the commission's Internet website.
84	84	(m) The commission or the commission's agent shall publicly
85	85	disclose, immediately after the committee deliberations conclude,
86	86	each specific drug recommended for or against preferred drug list
87	87	status for each drug class included in the preferred drug list for
88	88	the Medicaid vendor drug program. The disclosure must be posted on
89	89	the commission's Internet website not later than the 10th business
90	90	day [made in writing] after the conclusion of committee
91	91	deliberations that result in recommendations made to the executive
92	92	commissioner regarding the placement of drugs on the preferred drug
93	93	list. The public disclosure must include:
94	94	(1) the general basis for the recommendation for each
95	95	drug class; and
96	96	(2) for each recommendation, whether a supplemental
97	97	rebate agreement or a program benefit agreement was reached under
98	98	Section 531.070.
99	99	SECTION 5. Subchapter B, Chapter 531, Government Code, is
100	100	amended by adding Section 531.0741 to read as follows:
101	101	Sec. 531.0741. PUBLICATION OF INFORMATION REGARDING
102	102	COMMISSION DECISIONS ON PREFERRED DRUG LIST PLACEMENT. The
103	103	commission shall publish on the commission's Internet website any
104	104	decisions on preferred drug list placement, including:
105	105	(1) a list of drugs reviewed and the commission's
106	106	decision for or against placement on a preferred drug list of each
107	107	drug reviewed;
108	108	(2) for each recommendation, whether a supplemental
109	109	rebate agreement or a program benefit agreement was reached under
110	110	Section 531.070; and
111	111	(3) the rationale for any departure from a
112	112	recommendation of the pharmaceutical and therapeutics committee
113	113	established under Section 531.074.
114	114	SECTION 6. Not later than December 1, 2010, the executive
115	115	commissioner of the Health and Human Services Commission shall
116	116	implement Subsections (g) and (h), Section 531.073, Government
117	117	Code, as added by this Act.
118	118	SECTION 7. If before implementing any provision of this Act
119	119	a state agency determines that a waiver or authorization from a
120	120	federal agency is necessary for implementation of that provision,
121	121	the agency affected by the provision shall request the waiver or
122	122	authorization and may delay implementing that provision until the
123	123	waiver or authorization is granted.
124	124	SECTION 8. This Act takes effect September 1, 2009.
125	125	* * * * *