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S. B. No. 14As Introduced
As Introduced
| 125th General Assembly | | Regular Session | | 2003-2004 |
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SENATORS Hagan, DiDonato, Miller, Herington, Mallory, Fingerhut, Dann, Fedor, Roberts, Brady, Prentiss
A BILL
To amend section 329.04 and 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, 5110.28,
5110.40,
5110.42, 5110.44,
5110.50, 5110.60, and
5110.62 of
the Revised Code to create the Rx
Program; to
require the Director of Job and Family
Services,
on
making a specified determination, to
establish
maximum retail prices for prescription
drugs; to
authorize the Director to act
in the
event of a
severe
shortage of prescription drugs;
and to
authorize a civil action
for violation of
certain
prohibitions regarding pricing of
prescription
drugs.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That section 329.04 be amended and 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, 5110.28, 5110.40,
5110.42,
5110.44, 5110.50, 5110.60, and 5110.62 of the Revised
Code be
enacted to read as follows:
Sec. 329.04. (A) The county department of job and family
services shall
have, exercise, and perform the following powers
and duties: (1) Perform any duties assigned by
the state department of
job and family services
regarding the provision of public family
services, including the provision of the following services
to
prevent or reduce economic or
personal dependency and to
strengthen family life: (a) Services authorized by
a Title IV-A
program, as
defined in section 5101.80 of the Revised Code; (b) Social services authorized by Title XX of the
"Social
Security Act" and provided for by section 5101.46 of the Revised
Code; (c) If the county department is designated as the child
support
enforcement agency, services authorized by Title IV-D of
the "Social
Security
Act" and provided for by
Chapter 3125. of
the Revised Code. The county
department
may perform the services
itself or contract with other
government entities, and, pursuant
to division
(C) of section 2301.35 and section 2301.42 of the
Revised Code, private
entities, to perform the Title IV-D
services. (2) Administer disability assistance under Chapter 5115. of
the
Revised Code as required by the state department of job and
family services; (3) Administer burials insofar as the administration of
burials was,
prior to September 12, 1947, imposed upon the board
of county commissioners
and if otherwise required by state law; (4) Cooperate with state and federal authorities in any
matter
relating to family services and to act as the agent of
such
authorities; (5) Submit an annual account of its
work and expenses to the
board of county commissioners and to the
state department of job
and family services at the
close of each fiscal year; (6) Exercise any powers and duties
relating to family
services or workforce development
activities imposed upon the
county department of job and
family
services by law, by resolution
of the board of county commissioners, or by
order of the governor,
when authorized by law, to meet
emergencies during war or peace; (7) Determine the eligibility for medical assistance of
recipients of aid under Title XVI of the "Social Security Act"; (8) If assigned by the state director of job and
family
services under section 5101.515
of the Revised Code,
determine
applicants' eligibility for health assistance under the
children's
health insurance program part II; (9) Enter into a plan of cooperation with the board of
county
commissioners under section 307.983, consult with
the board
in the development of the transportation work plan developed under
section 307.985, establish with the board procedures
under section
307.986 for
providing services to children whose families relocate
frequently, and comply
with the
contracts the board enters into
under sections 307.981 and 307.982 of the
Revised Code that affect
the county department; (10) For the purpose of complying with a partnership
agreement the board
of county commissioners enters into under
section 307.98 of the Revised Code, exercise the
powers and
perform the duties the partnership agreement assigns to the county
department; (11) If the county department is designated as the workforce
development
agency, provide the workforce development activities
specified in the contract
required by section 330.05 of the
Revised Code; (12) Accept applications for the Rx program created by section 5110.02 of the Revised Code and make eligibility determinations for the program. (B) The powers and duties of a county department of job and
family services are, and
shall be exercised and performed, under
the control and direction of the board
of county commissioners.
The board may assign to the county department any
power or duty of
the board regarding family services
and workforce development
activities. If the new power or duty
necessitates the state
department of job and family
services changing its federal cost
allocation plan, the county department may not implement the power
or duty
unless the United States department of health and human
services approves the
changes.
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 meets all of the following
requirements is
eligible to participate in the Rx
program. (A) The individual is a resident of this state. (B) Except as provided in section 5110.03 of the Revised
Code,
the individual is not eligible for a program under which
federal, state,
or county funds are used to pay part or all of the
cost of the
individual's prescription drugs. (C) The individual does not have prescription drug coverage
through a third-party payer, as defined in section 3901.38 of the
Revised Code.
Sec. 5110.12. An individual seeking to participate in the Rx
program shall apply to the county department of job and family
services
of the county in which the individual resides.
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 shall 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.
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. 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
maintain a list of manufacturers of dangerous drugs and wholesale
distributors of dangerous drugs that do not enter into a rebate
agreement with the director under section 5110.25 of the Revised
Code. The director shall make the list
available to the public.
Sec. 5110.40. Not later than April 1, 2005, the director of
job
and family services shall do all of the following: (A) Review medicaid recipients' use of prescription drugs
and
create a list of the one hundred prescription drugs most used
by
medicaid recipients and the one hundred prescription drugs for
which the total cost was the highest. To make this determination,
the director shall use data from the most recent six-month period
for which such data is available. (B) Determine the average amount terminal distributors of
dangerous drugs charged Rx program participants for each
prescription
drug included on the list created under division (A)
of
this section on a date selected by the director; (C) Determine the average amount terminal distributors of
dangerous drugs charged persons other than Rx program
participants
for each prescription drug included on the list created under
division (A) of this section on the date selected by the director
under division (B) of this section.
Sec. 5110.42. If the director of job and family services
determines under section 5110.40 of the Revised Code that
the
average amount terminal distributors of dangerous drugs charged
Rx
program
participants for one or more prescription drugs included
on the list the
director created under division (A) of that
section is not
reasonably comparable to the average amount
terminal distributors charged
persons other than Rx
program
participants for the same prescription drug, the director shall
adopt rules in accordance
with Chapter 119. of the Revised Code
establishing
maximum amounts
terminal distributors of dangerous
drugs may charge in this state for any or
all prescription drugs.
If required to adopt the rules, the director shall
adopt the
rules
not later than October 1, 2005. The rules shall permit a
terminal
distributor of dangerous drugs to appeal the maximum price a rule
establishes for a
prescription drug in accordance with Chapter
119. of the Revised
Code.
Sec. 5110.44. (A) No terminal distributor of dangerous
drugs
shall charge more for a prescription drug than permitted by
rules adopted
under section 5110.42 of the Revised Code.
(B) A terminal distributor of dangerous drugs that violates
division (A) of this
section commits an unfair or deceptive act or
practice in violation of
section 1345.02 of the Revised Code.
Sec. 5110.50. If the director of job and family services
determines that there is a severe shortage of prescription drugs
in this
state that could threaten the public health or welfare,
the director may
take actions the director determines necessary.
Sec. 5110.60. (A) No manufacturer of dangerous drugs,
wholesale
distributor of dangerous drugs, or terminal distributor
of dangerous
drugs shall do any of the following: (1) Demand an unconscionable price for a prescription drug; (2) Demand prices or terms for a prescription drug that
lead to
an unjust or unreasonable profit; (3) Discriminate unreasonably against any person in the
sale,
exchange, distribution, or handling of a prescription drug
dispensed or
delivered in this state.
(B) A manufacturer of dangerous drugs, wholesale distributor
of
dangerous drugs, or terminal distributor of dangerous drugs
that violates this
section is liable in a civil action for all of
the following: (1) An amount equal to three times the amount of the injury
caused by the violation; (2) An amount not to exceed one hundred thousand dollars; (3) The cost of bringing and prosecuting the action,
including
necessary and reasonable investigative costs, reasonable
expert fees,
and reasonable attorney's fees; (4) In the case of a willful violation or a determination
that the
manufacturer of
dangerous drugs, wholesale distributor of
dangerous drugs, or terminal
distributor of dangerous drugs
previously has been found liable under this
section, punitive
damages.
Sec. 5110.62. On behalf of a person, group of persons, state
agency, or political subdivision injured by a violation of section
5110.60 of the Revised Code, the attorney general may bring
a
civil action against the manufacturer of dangerous drugs,
wholesale
distributor of dangerous drugs, or terminal distributor
of dangerous drugs
whose
violation of that section caused the
injury. There is a right to
a jury trial in a civil action
brought under this section. In
addition to the awards provided by
division (B) of section 5110.60
of the Revised Code, the attorney
general may obtain
injunctive
relief. If punitive damages are
awarded, the attorney general shall equitably
distribute the
damages to all injured parties, less
reasonable costs to the
attorney general for distributing the
damages.
Section 2. That existing section 329.04 of the Revised Code
is
hereby repealed.
Section 3. Sections 1 and 2 of this act take effect
January 1, 2004.
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