HB594: relative to the medicaid pharmacy benefits management program.

CHAPTER 19

HB 594-FN – FINAL VERSION

11Mar2009… 0482h

2009 SESSION

09-0240

01/09

HOUSE BILL 594-FN

AN ACT relative to the medicaid pharmacy benefits management program.

SPONSORS: Rep. Case, Rock 1; Rep. Emerson, Ches 7; Rep. Rosenwald, Hills 22; Sen. D'Allesandro, Dist 20

COMMITTEE: Health, Human Services and Elderly Affairs

AMENDED ANALYSIS

This bill changes the name and membership of the committee charged with advising the commissioner of the department of health and human services on the Medicaid pharmacy benefits program to conform with federal law.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

11Mar2009… 0482h

09-0240

01/09

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Nine

AN ACT relative to the medicaid pharmacy benefits management program.

Be it Enacted by the Senate and House of Representatives in General Court convened:

19:1 Department of Health and Human Services; Medicaid Pharmacy Benefits Management Program. 2002; 281:9, III(a) and (b) as amended by 2003: 319:176 to be paragraph VI is repealed and reenacted to read as follows:

VI.(a) The pharmacy and therapeutics advisory committee shall be joined with the Drug Use Review Board mandated by 42 U.S.C., section 1396r-8(g)(3). The new committee shall be known as the New Hampshire drug use review board and shall follow the federal requirements for membership and activities as provided in 42 U.S.C., section 1396r-8(g)(3)(B-D). The drug use review board shall also advise the department on the operation of the Medicaid pharmacy benefits management program, including the medications subject to prior authorization, the criteria for approving prior authorization including consideration of medical necessity, and the criteria for the pharmacy lock-in program designed to prevent recipients from obtaining excessive quantities of, or from inappropriately using, prescription drugs through multiple pharmacies.

(1) The membership of the board shall include health care professionals who have recognized knowledge and expertise in one or more of the following areas:

(A) The clinically appropriate prescribing of covered outpatient drugs.

(B) The clinically appropriate dispensing and monitoring of covered outpatient drugs.

(C) Drug use review, evaluation, and intervention.

(D) Medical quality assurance.

(2) The membership of the board shall be made up of at least 1/3, but no more than 51 percent licensed and actively practicing physicians and at least 1/3 of licensed and actively practicing pharmacists.

(b) In determining which medications shall be subject to prior authorization and in establishing the criteria for approving prior authorization or any changes thereto, the board shall hold a public hearing to be scheduled at a time and place chosen to afford opportunity for the public to present its views. The board shall give public notice of any hearing at least 30 days in advance of the hearing. Public notice shall include a public notice advertisement in a publication of daily statewide circulation.

(c) The commissioner shall adopt rules, pursuant to RSA 541-A, to implement this paragraph.

19:2 Effective Date. This act shall take effect upon its passage.

Approved: May 4, 2009

Effective Date: May 4, 2009