AN ACT relating to the Medicaid outpatient pharmacy program.
     Create a new section of KRS 205.510 to 205.645 to create the pharmacy and therapeutics committee and attach to the Department for Medicaid Services; establish the membership at 14 members, 12 of whom shall be physicians or pharmacists, to be appointed by the Governor; require the committee to act in an advisory capacity to the Governor, the Cabinet for Health Services, and the Medicaid commissioner on the development and administration of an outpatient drug formulary, to perform drug reviews and make recommendations on prior authorization, provide for an appeals process, and establish bylaws for the conduct of meetings; provide for a quorum of 7 members; require the committee to meet every other month or upon the call of the chair, the cabinet secretary, or the Governor; require posting of the agenda on the web site; provide for reimbursement of members' travel expenses associated with attending meetings; require the secretary to review recommendations on prior authorization and present the basis for any rejection of recommendations at the next regularly scheduled meeting of the committee; require the Cabinet for Health Services to promulgate administrative regulations relating to the committee; amend KRS 205.5631 to amend the definition of "new drug" and to delete the definition of "available; amend KRS 205.5632 to provide that a new drug shall be exempt from prior authorization unless the committee and secretary have made a final determination that prior authorization should be required, and provide for review within 75 days for new drugs requiring prior authorization because the drugs are in a specific class that has been deemed as requiring prior authorization; delete provisions requiring drugs of comparable clinical application, efficacy, and safety of a nonprior authorized drug to also be placed on the nonprior authorized drug file; amend KRS 205.5634 to delete the provision that the commissioner may prior authorize drugs due to safety or financial burden reasons; amend KRS 205.2638 to require the Drug Management Review Advisory Board to recommend, rather than establish, standards for the identification of suspected fraud and abuse, and delete the requirement that the board advise the Department for Medicaid Services on outpatient drug coverage; confirm Executive Order 2001-1243, dated October 2, 2001, to the extent it is not otherwise confirmed or superseded; and provide for the initial appointments to the committee.

     (Prefiled by the sponsor(s))

     Jan 8-introduced in Senate
     Jan 10-to Health and Welfare (S)