|
The online versions of legislation provided on this website are not official. Enrolled bills are the final version passed by the Ohio General Assembly and presented to the Governor for signature. The official version of acts signed by the Governor are available from the Secretary of State's Office in the Continental Plaza, 180 East Broad St., Columbus.
|
H. B. No. 290As Introduced
As Introduced
| 124th General Assembly | | Regular Session | | 2001-2002 |
| |
REPRESENTATIVES D. Miller, Jerse, Patton, Barnes, Britton, Distel, Sykes, Allen, Cirelli, Jones, Strahorn, Barrett, Fedor, Beatty, Key, Krupinski, Metelsky, Sferra, Lendrum, S. Smith, Woodard, Boccieri, Rhine, Coates, Carano
A BILL
To enact sections
5110.01, 5110.02,
5110.03,
5110.04, 5110.06,
5110.07, 5110.08, 5110.09,
5110.10,
5110.12,
5110.15, 5110.16, 5110.18,
5110.19, 5110.20,
5110.21,
5110.25, 5110.26,
5110.27, and 5110.28 of the Revised
Code to create
the Rx
Program.
Section 1. That sections
5110.01,
5110.02, 5110.03,
5110.04, 5110.06, 5110.07, 5110.08,
5110.09,
5110.10, 5110.12,
5110.15, 5110.16, 5110.18, 5110.19,
5110.20,
5110.21, 5110.25,
5110.26, 5110.27, and 5110.28
of the Revised
Code be
enacted to
read as follows:
Sec. 5110.01. As used in this chapter: (A) "Manufacturer of dangerous drugs," "terminal distributor
of
dangerous drugs," and "wholesale distributor of dangerous
drugs" have the
same meanings as in section 4729.01 of the Revised
Code.
(B) "Medicaid" has the same meaning as in section 5111.01 of
the
Revised Code. (C) "Prescription drug" means a dangerous drug as defined in
division (F)(1) of section 4729.01 of the Revised
Code. (D) "Rx program participant" means an individual
determined
eligible for the Rx program and issued an Rx
program enrollment
card.
(E) "State health program" means a health program that is
funded
in whole or part with state funds or administered by a
state agency.
Sec. 5110.02. There is hereby established in the department
of
job and family services the
Rx
program. An
Rx
program
participant shall
receive
an
Rx
program enrollment card to be
presented to
terminal
distributors of dangerous drugs to receive
discounts provided for
under
section 5110.15 of the Revised Code
on prescription drugs
covered
by the program pursuant to section
5110.27 of the Revised
Code.
Sec. 5110.03. The director of job and family services may
coordinate the
Rx
program with other programs administered by
the
director or,
pursuant to an interagency agreement, directors of
other state
departments, to enhance efficiency, reduce the cost of
prescription drugs, and maximize the benefits of the
Rx
program
and other programs. Coordination may include making participants
of other programs eligible for the
Rx
program.
Sec. 5110.04. There is hereby created in the state treasury
the
Rx
program fund. The fund shall consist of rebates made by
manufacturers of dangerous drugs and wholesale distributors of
dangerous
drugs pursuant to rebate agreements entered into under
section
5110.25 of the Revised Code and money the general assembly
appropriates for the
Rx
program. The director of job and family
services shall use
money in the fund to reimburse a terminal
distributor of dangerous
drugs the amount of the discount the
terminal distributor provides
an
Rx
program participant on a
prescription drug pursuant to
section 5110.15 of the Revised Code
and pay the terminal
distributor a professional fee established by
rules adopted under
section
5110.06 of the Revised Code. The
director shall also use
money in the fund to pay the
administrative costs of the
Rx
program, including
administrative
costs associated with
contracted
services, computers, and other
reasonable
administrative matters.
Investment earnings of the
fund
shall be
credited to the fund.
Sec. 5110.06. The director of job and family services shall
adopt
rules in
accordance with Chapter 119. of the Revised
Code to
implement the
Rx
program. The rules shall provide for all of
the
following: (A)
Simplified eligibility determination procedures for the
Rx
program; (B)
The manner in which a terminal distributor of dangerous
drugs
shall disclose to an
Rx
program participant the amount the
program has saved
the participant on the cost of a prescription
drug
covered by the
Rx
program that the participant purchases from
the
terminal distributor. The rules shall not require a terminal
distributor of dangerous drugs to reveal any proprietary
information. (C)
Claim forms to be used by a terminal distributor of
dangerous
drugs under section 5110.18 of the Revised Code; (D)
The amount of the professional fee to be paid to
terminal
distributors of
dangerous drugs pursuant to section
5110.19 of the
Revised
Code. The professional fee shall be three
dollars
initially. The
director shall review the professional-fee
amount
periodically
to determine whether it should be increased.
(E) A schedule for manufacturers of dangerous drugs and
wholesale
distributors of dangerous drugs to pay rebates to the
director
pursuant to a rebate agreement entered into under section
5110.25
of the Revised Code; (F)
Notwithstanding this chapter, adjustments to the
requirements
and terms of the
Rx
program to accommodate any
federally
funded prescription drug programs created after the
effective date of
this section.
Sec. 5110.07. The director of job and family services shall
seek
a waiver of
federal law or regulation if necessary to
implement the
Rx
program.
Sec. 5110.08. The director of job and family services shall
report enrollment
in and the financial status of the
Rx
program to
the speaker and
minority leader of the house of representatives
and the president
and minority leader of the senate not later than
the second week
of each January.
Sec. 5110.09. The director of job and family services shall
undertake
outreach efforts to publicize the
Rx
program and
maximize
enrollment in the program.
Sec. 5110.10. An individual who is a resident of this state
is
eligible to participate in the
Rx
program.
Sec. 5110.12. An individual seeking to participate in the
Rx
program shall apply to the Ohio department of job and family
services.
Sec. 5110.15. Each terminal distributor of dangerous drugs
shall
discount the amount it charges an
Rx
program participant for
a
prescription drug covered by the program. The amount of the
discount
shall be the amount of the rebate a manufacturer of
dangerous
drugs or wholesale distributor of dangerous drugs pays
the
director of job and family services for the prescription drug
pursuant to a
rebate agreement entered into under section 5110.25
of the Revised
Code.
Sec. 5110.16. In accordance with rules adopted under section
5110.06 of the Revised Code, a terminal distributor of
dangerous
drugs shall disclose to an
Rx
program participant the amount
the
program has
saved the participant on the cost of a prescription
drug covered by the
program that the participant purchases from
the terminal
distributor.
Sec. 5110.18. A terminal distributor of dangerous drugs that
provides an
Rx
program participant a discount on a
prescription
drug
pursuant to section 5110.15 of the Revised Code shall submit
a
claim to the director of job and family services verifying the
amount the
terminal distributor charged the participant for the
prescription
drug. The
terminal distributor shall use a claim
form prescribed
in rules
adopted under section 5110.06 of the
Revised Code.
Sec. 5110.19. Using claims submitted by a terminal
distributor of
dangerous drugs under section 5110.18 of the
Revised Code,
the
director of job and family services shall
reimburse a terminal
distributor of dangerous drugs the amount of
the discount the
terminal distributor provides an
Rx
program
participant on a
prescription drug pursuant to section 5110.15 of
the Revised
Code
and pay the terminal distributor the professional
fee established
by rules
adopted under section 5110.06 of the
Revised Code for
each
claim. The director shall make the
reimbursements and
payments on a
weekly or biweekly basis.
Sec. 5110.20. The director of job and family services shall
not
impose a
transaction charge on a terminal distributor of
dangerous drugs
that submits a claim under section 5110.18 of the
Revised
Code.
Sec. 5110.21. The director of job and family services shall
not
release any
information included on a claim submitted to the
director
under
section 5110.18 of the Revised Code that is subject
to
confidentiality protection under federal or state law.
Sec. 5110.25. Each manufacturer of dangerous drugs and
wholesale
distributor of dangerous drugs that sells prescription
drugs
through a state health program may enter into a rebate
agreement
with the director of job and family services under which
the
manufacturer
or wholesale distributor is to make rebate
payments
to the
director on a quarterly basis or in accordance
with a
schedule
established by rules adopted under section 5110.06
of the
Revised
Code.
Sec. 5110.26. The director of job and family services shall
negotiate with
each manufacturer of dangerous drugs and wholesale
distributor of
dangerous drugs that enters into a rebate agreement
with
the
director under section 5110.25 of the Revised Code
the
amount of
the rebate the manufacturer or wholesale distributor
shall pay
to
the director under that section. In the process of
negotiations,
the director shall do both of the following: (A)
Take into consideration rebates provided for under 42
U.S.C.A.
1396r-8, the average wholesale price of prescription
drugs,
and
any other information on prescription drug prices and
price discounts available to the
director;
(B)
Use the director's best efforts to obtain a rebate
amount
that is at least as much as the amount of the rebate
provided for
under
42 U.S.C.A. 1396r-8 or not
less than the amount
the federal
government receives as a discount, rebate, or price
reduction for
prescription drugs.
Sec. 5110.27. The
Rx
program shall cover a prescription
drug
if
the prescription drug is included in a rebate agreement entered
into
under section 5110.25 of the Revised Code.
Sec. 5110.28. The director of job and family services shall
do both of the
following with respect to manufacturers of
dangerous drugs and
wholesale distributors of dangerous drugs that
do not enter into a
rebate agreement under section 5110.25 of the
Revised Code:
(A) Maintain a list of all those manufacturers and
wholesale distributors and make it available to the public;
(B) Require all prescription drugs manufactured by those
manufacturers and distributed by those wholesale distributors to
receive prior authorization by the department of job and family
services pursuant to 42 U.S.C. 1396r-8 before the costs of those
drugs may be reimbursed under medicaid. |
|
