By: Uresti S.B. No. 1536
(In the Senate - Filed March 9, 2009; March 17, 2009, read
first time and referred to Committee on Health and Human Services;
May 5, 2009, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 9, Nays 0; May 5, 2009, sent
to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 1536 By: Uresti
A BILL TO BE ENTITLED
AN ACT
relating to preferred drug lists adopted by the Health and Human
Services Commission and associated requirements regarding
supplemental rebates, prior authorization, and public
notification.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 531.071, Government Code, is amended by
amending Subsection (c) and adding Subsection (d) to read as
follows:
(c) General information about the aggregate costs of
different classes of drugs is not confidential under Subsection
(a), except that a drug name or information that could reveal a drug
name is confidential.
(d) Information about whether the commission and a
manufacturer or labeler reached or did not reach a supplemental
rebate agreement under Section 531.070 for a particular drug is not
confidential under Subsection (a).
SECTION 2. Section 531.072, Government Code, is amended by
adding Subsections (b-1), (b-2), and (c-1) to read as follows:
(b-1) Notwithstanding Subsection (b), the preferred drug
lists may contain:
(1) a drug provided by a manufacturer or labeler that
has not reached a supplemental rebate agreement with the commission
if the commission determines that inclusion of the drug on the
preferred drug lists will have no negative cost impact to the state;
or
(2) a drug provided by a manufacturer or labeler that
has reached an agreement with the commission to provide program
benefits in lieu of supplemental rebates, as described by Section
531.070.
(b-2) Consideration must be given to including all
strengths and dosage forms of a drug on the preferred drug lists.
(c-1) In addition to the considerations listed under
Subsection (c), the commission shall consider the inclusion of
multiple methods of delivery within each drug class, including
liquid, tablet, capsule, and orally disintegrating tablets.
SECTION 3. Section 531.073, Government Code, is amended by
adding Subsections (g) and (h) to read as follows:
(g) The commission shall ensure that requests for prior
authorization may be submitted by telephone, facsimile, or
electronic communications through the Internet.
(h) The commission shall provide an automated process that
may be used to assess a Medicaid recipient's medical and drug claim
history to determine whether the recipient's medical condition
satisfies the applicable criteria for dispensing a drug without an
additional prior authorization request.
SECTION 4. Section 531.074, Government Code, is amended by
amending Subsections (i) and (m) and adding Subsections (f-1) and
(i-1) to read as follows:
(f-1) The committee shall meet in public and shall permit
public comment before voting on any changes in the preferred drug
lists. Minutes of each meeting shall be made available to the
public not later than the 10th business day after the date the
minutes are approved. The committee may meet in executive session
to discuss confidential information as described by Subsection (i).
(i) The commission shall adopt rules governing the
operation of the committee, including rules governing the
procedures used by the committee for providing notice of a meeting
and rules prohibiting the committee from discussing confidential
information described by Section 531.071 in a public meeting. The
committee shall comply with the rules adopted under this subsection
and Subsection (i-1).
(i-1) In addition to the rules under Subsection (i), the
commission by rule shall require the committee or the committee's
designee to present a summary of any clinical efficacy and safety
information or analyses regarding a drug under consideration for a
preferred drug list that is provided to the committee by a private
entity that has contracted with the commission to provide the
information. The committee or the committee's designee shall
provide the summary in electronic form before the public meeting at
which consideration of the drug occurs. Confidential information
described by Section 531.071 must be omitted from the summary. The
summary must be posted on the commission's Internet website.
(m) The commission or the commission's agent shall publicly
disclose, immediately after the committee deliberations conclude,
each specific drug recommended for or against preferred drug list
status for each drug class included in the preferred drug list for
the Medicaid vendor drug program. The disclosure must be posted on
the commission's Internet website not later than the 10th business
day [made in writing] after the conclusion of committee
deliberations that result in recommendations made to the executive
commissioner regarding the placement of drugs on the preferred drug
list. The public disclosure must include:
(1) the general basis for the recommendation for each
drug class; and
(2) for each recommendation, whether a supplemental
rebate agreement or a program benefit agreement was reached under
Section 531.070.
SECTION 5. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.0741 to read as follows:
Sec. 531.0741. PUBLICATION OF INFORMATION REGARDING
COMMISSION DECISIONS ON PREFERRED DRUG LIST PLACEMENT. The
commission shall publish on the commission's Internet website any
decisions on preferred drug list placement, including:
(1) a list of drugs reviewed and the commission's
decision for or against placement on a preferred drug list of each
drug reviewed;
(2) for each recommendation, whether a supplemental
rebate agreement or a program benefit agreement was reached under
Section 531.070; and
(3) the rationale for any departure from a
recommendation of the pharmaceutical and therapeutics committee
established under Section 531.074.
SECTION 6. Not later than December 1, 2010, the executive
commissioner of the Health and Human Services Commission shall
implement Subsections (g) and (h), Section 531.073, Government
Code, as added by this Act.
SECTION 7. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 8. This Act takes effect September 1, 2009.
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