By: Van de Putte S.B. No. 1645
(In the Senate - Filed March 10, 2009; March 20, 2009, read
first time and referred to Committee on Health and Human Services;
May 1, 2009, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 9, Nays 0; May 1, 2009, sent
to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 1645 By: Deuell
A BILL TO BE ENTITLED
AN ACT
relating to a study of the feasibility of establishing separate
reimbursement under the Medicaid vendor drug program for certain
pharmacy care management services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. DEFINITION. In this Act, "pharmacy care
management services" means services provided by a pharmacy to
support patients receiving treatment or therapy through a specialty
pharmacy drug or therapy and maximize adherence to the drug or
therapy, including:
(1) significant caregiver and provider contact and
education regarding the relevant disease, disease prevention and
treatment, and counseling related to drug indications, benefits,
risks, complications, and appropriate use of the prescribed drug or
therapy;
(2) patient compliance services, including
coordination of provider visits with delivery of the specialty drug
or therapy to the provider, compliance with the dosing regimen,
patient reminders, compilation of data, and assisting providers in
the development of compliance programs; and
(3) tracking services, including developing ordering
processes with a provider, screening referrals, and tracking a
patient's weight for dosing requirements.
SECTION 2. STUDY. (a) The Health and Human Services
Commission shall study the feasibility of establishing separate
reimbursement rates under the Medicaid vendor drug program for
pharmacies that provide pharmacy care management services to
patients who are administered specialty pharmacy drugs, including
drugs indicated for the prophylaxis of respiratory syncytial virus,
blood factor, or any other biologic or therapy that requires
complex care.
(b) In conducting the study under Subsection (a) of this
section, the Health and Human Services Commission shall consult
with the Centers for Medicare and Medicaid Services and may
consider the adoption of pharmacy care management services
reimbursement for pharmacy services adopted by other state Medicaid
programs.
(c) The Health and Human Services Commission shall seek
information from specialty pharmacy providers or other sources
regarding the costs of providing pharmacy care management services.
(d) Not later than September 1, 2010, the Health and Human
Services Commission shall submit a written report of the results of
the study conducted under Subsection (a) of this section to the
legislature.
SECTION 3. EFFECTIVE DATE. This Act takes effect
immediately if it receives a vote of two-thirds of all the members
elected to each house, as provided by Section 39, Article III, Texas
Constitution. If this Act does not receive the vote necessary for
immediate effect, this Act takes effect September 1, 2009.
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