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AN ACT
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relating to the distribution of a prescription drug and a study of |
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the feasibility of establishing separate reimbursement under the |
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Medicaid vendor drug program for certain pharmacy care management |
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services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. DEFINITION. In this Act, "pharmacy care |
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management services" means services provided by a pharmacy to |
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support patients receiving treatment or therapy through a specialty |
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pharmacy drug or therapy and maximize adherence to the drug or |
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therapy, including: |
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(1) significant caregiver and provider contact and |
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education regarding the relevant disease, disease prevention and |
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treatment, and counseling related to drug indications, benefits, |
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risks, complications, and appropriate use of the prescribed drug or |
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therapy; |
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(2) patient compliance services, including |
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coordination of provider visits with delivery of the specialty drug |
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or therapy to the provider, compliance with the dosing regimen, |
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patient reminders, compilation of data, and assisting providers in |
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the development of compliance programs; and |
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(3) tracking services, including developing ordering |
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processes with a provider, screening referrals, and tracking a |
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patient's weight for dosing requirements. |
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SECTION 2. STUDY. (a) The Health and Human Services |
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Commission shall study the feasibility of establishing separate |
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reimbursement rates under the Medicaid vendor drug program for |
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pharmacies that provide pharmacy care management services to |
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patients who are administered specialty pharmacy drugs, including |
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drugs indicated for the prophylaxis of respiratory syncytial virus, |
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blood factor, or any other biologic or therapy that requires |
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complex care. |
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(b) In conducting the study under Subsection (a) of this |
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section, the Health and Human Services Commission shall consult |
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with the Centers for Medicare and Medicaid Services and may |
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consider the adoption of pharmacy care management services |
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reimbursement for pharmacy services adopted by other state Medicaid |
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programs. |
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(c) The Health and Human Services Commission shall seek |
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information from specialty pharmacy providers or other sources |
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regarding the costs of providing pharmacy care management services. |
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(d) Not later than September 1, 2010, the Health and Human |
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Services Commission shall submit a written report of the results of |
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the study conducted under Subsection (a) of this section to the |
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legislature. |
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SECTION 3. NORMAL DISTRIBUTION CHANNEL. Subdivision (5), |
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Section 431.401, Health and Safety Code, is amended to read as |
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follows: |
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(5) "Normal distribution channel" means a chain of |
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custody for a prescription drug, either directly or by drop |
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shipment, from the manufacturer of the prescription drug, the |
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manufacturer to the manufacturer's co-licensed product partner, |
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the manufacturer to the manufacturer's third-party logistics |
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provider, or the manufacturer to the manufacturer's exclusive |
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distributor, to: |
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(A) a pharmacy to: |
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(i) a patient; or |
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(ii) another designated person authorized |
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by law to dispense or administer the drug to a patient; |
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(B) an authorized distributor of record to: |
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(i) a pharmacy to a patient; or |
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(ii) another designated person authorized |
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by law to dispense or administer the drug to a patient; |
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(C) an authorized distributor of record to a |
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wholesale distributor licensed under this chapter to another |
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designated person authorized by law to administer the drug to a |
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patient; |
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(D) an authorized distributor of record to a |
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pharmacy warehouse to the pharmacy warehouse's intracompany |
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pharmacy; |
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(E) [(D)] a pharmacy warehouse to the pharmacy |
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warehouse's intracompany pharmacy or another designated person |
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authorized by law to dispense or administer the drug to a patient; |
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(F) [(E)] a person authorized by law to prescribe |
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a prescription drug that by law may be administered only under the |
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supervision of the prescriber; or |
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(G) [(F)] an authorized distributor of record to |
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one other authorized distributor of record to a licensed |
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practitioner for office use. |
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SECTION 4. EXEMPTION FROM CERTAIN PROVISIONS FOR CERTAIN |
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WHOLESALE DISTRIBUTORS. Section 431.4031, Health and Safety Code, |
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is amended to read as follows: |
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Sec. 431.4031. EXEMPTION FROM CERTAIN PROVISIONS FOR |
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CERTAIN WHOLESALE DISTRIBUTORS. (a) A wholesale distributor that |
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distributes prescription drugs that are medical gases or a |
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wholesale distributor that is a manufacturer or a third-party |
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logistics provider on behalf of a manufacturer is exempt from |
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Sections 431.404(a)(5) and (6), (b), and (c), 431.4045(2), 431.405, |
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431.407, and 431.408. |
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(b) A state agency or a political subdivision of this state |
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that distributes prescription drugs using federal or state funding |
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to nonprofit health care facilities or local mental health or |
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mental retardation authorities for distribution to a pharmacy, |
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practitioner, or patient is exempt from Sections 431.405(b), |
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431.407, 431.408, 431.412, and 431.413. |
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(c) The executive commissioner of the Health and Human |
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Services Commission by rule may exempt specific purchases of |
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prescription drugs by state agencies and political subdivisions of |
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this state if the executive commissioner determines that the |
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requirements of this subchapter would result in a substantial cost |
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to the state or a political subdivision of the state. |
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SECTION 5. RULES. As soon as practicable after the |
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effective date of this Act, the executive commissioner of the |
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Health and Human Services Commission shall adopt, modify, or repeal |
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rules as necessary to implement the changes in law made by this Act |
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to Chapter 431, Health and Safety Code. |
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SECTION 6. EFFECTIVE DATE. This Act takes effect |
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immediately if it receives a vote of two-thirds of all the members |
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elected to each house, as provided by Section 39, Article III, Texas |
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Constitution. If this Act does not receive the vote necessary for |
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immediate effect, this Act takes effect September 1, 2009. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 1645 passed the Senate on |
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May 7, 2009, by the following vote: Yeas 31, Nays 0; May 30, 2009, |
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Senate refused to concur in House amendment and requested |
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appointment of Conference Committee; May 30, 2009, House granted |
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request of the Senate; May 31, 2009, Senate adopted Conference |
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Committee Report by the following vote: Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 1645 passed the House, with |
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amendment, on May 27, 2009, by the following vote: Yeas 137, |
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Nays 11, one present not voting; May 30, 2009, House granted |
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request of the Senate for appointment of Conference Committee; |
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May 31, 2009, House adopted Conference Committee Report by the |
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following vote: Yeas 141, Nays 0, one present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |