S.B. No. 1645
AN ACT
relating to the distribution of a prescription drug and 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. NORMAL DISTRIBUTION CHANNEL. Subdivision (5),
Section 431.401, Health and Safety Code, is amended to read as
follows:
(5) "Normal distribution channel" means a chain of
custody for a prescription drug, either directly or by drop
shipment, from the manufacturer of the prescription drug, the
manufacturer to the manufacturer's co-licensed product partner,
the manufacturer to the manufacturer's third-party logistics
provider, or the manufacturer to the manufacturer's exclusive
distributor, to:
(A) a pharmacy to:
(i) a patient; or
(ii) another designated person authorized
by law to dispense or administer the drug to a patient;
(B) an authorized distributor of record to:
(i) a pharmacy to a patient; or
(ii) another designated person authorized
by law to dispense or administer the drug to a patient;
(C) an authorized distributor of record to a
wholesale distributor licensed under this chapter to another
designated person authorized by law to administer the drug to a
patient;
(D) an authorized distributor of record to a
pharmacy warehouse to the pharmacy warehouse's intracompany
pharmacy;
(E) [(D)] a pharmacy warehouse to the pharmacy
warehouse's intracompany pharmacy or another designated person
authorized by law to dispense or administer the drug to a patient;
(F) [(E)] a person authorized by law to prescribe
a prescription drug that by law may be administered only under the
supervision of the prescriber; or
(G) [(F)] an authorized distributor of record to
one other authorized distributor of record to a licensed
practitioner for office use.
SECTION 4. EXEMPTION FROM CERTAIN PROVISIONS FOR CERTAIN
WHOLESALE DISTRIBUTORS. Section 431.4031, Health and Safety Code,
is amended to read as follows:
Sec. 431.4031. EXEMPTION FROM CERTAIN PROVISIONS FOR
CERTAIN WHOLESALE DISTRIBUTORS. (a) A wholesale distributor that
distributes prescription drugs that are medical gases or a
wholesale distributor that is a manufacturer or a third-party
logistics provider on behalf of a manufacturer is exempt from
Sections 431.404(a)(5) and (6), (b), and (c), 431.4045(2), 431.405,
431.407, and 431.408.
(b) A state agency or a political subdivision of this state
that distributes prescription drugs using federal or state funding
to nonprofit health care facilities or local mental health or
mental retardation authorities for distribution to a pharmacy,
practitioner, or patient is exempt from Sections 431.405(b),
431.407, 431.408, 431.412, and 431.413.
(c) The executive commissioner of the Health and Human
Services Commission by rule may exempt specific purchases of
prescription drugs by state agencies and political subdivisions of
this state if the executive commissioner determines that the
requirements of this subchapter would result in a substantial cost
to the state or a political subdivision of the state.
SECTION 5. RULES. As soon as practicable after the
effective date of this Act, the executive commissioner of the
Health and Human Services Commission shall adopt, modify, or repeal
rules as necessary to implement the changes in law made by this Act
to Chapter 431, Health and Safety Code.
SECTION 6. 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.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 1645 passed the Senate on
May 7, 2009, by the following vote: Yeas 31, Nays 0; May 30, 2009,
Senate refused to concur in House amendment and requested
appointment of Conference Committee; May 30, 2009, House granted
request of the Senate; May 31, 2009, Senate adopted Conference
Committee Report by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 1645 passed the House, with
amendment, on May 27, 2009, by the following vote: Yeas 137,
Nays 11, one present not voting; May 30, 2009, House granted
request of the Senate for appointment of Conference Committee;
May 31, 2009, House adopted Conference Committee Report by the
following vote: Yeas 141, Nays 0, one present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor