HOUSE BILL No. 5438

 

January 27, 2004, Introduced by Reps. Zelenko, Stahl, Vander Veen, Taub, Woronchak, Julian, Wojno, Shaffer, Amos, Steil, Mortimer, Howell, Voorhees, Middaugh, Plakas, Kooiman, Robertson, Dennis, Pappageorge, Minore, Richardville, Farhat, Hummel, Ehardt, Pumford, LaSata, Hager, Garfield, Caul, Stakoe, Woodward, DeRossett, Ruth Johnson, Palmer, Shackleton, Meyer, Koetje, Stewart, Caswell, Nitz, Milosch, Tabor, Nofs, Gaffney, Ward, Hune, Van Regenmorter, Vagnozzi, Spade, O'Neil, Jamnick, Murphy, Moolenaar, Huizenga, Walker and Palsrok and referred to the Committee on Health Policy.

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1984 PA 233, entitled                                             

                                                                                

    "Prudent purchaser act,"                                                    

                                                                                

    by amending section 2 (MCL 550.52) and by adding sections 3c, 3d,           

                                                                                

    3e, 3f, and 3g.                                                             

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 2.  As used in this act:                                               

                                                                                

2       (a) "Commissioner" means the commissioner of insurance.                     

                                                                                

3       (b) "Dental care corporation" means a dental care                           

                                                                                

4   corporation incorporated under  Act No. 125 of the Public Acts of           

                                                                                

5   1963, being sections 550.351 to 550.373 of the Michigan Compiled            

                                                                                

6   Laws  1963 PA 125, MCL 550.351 to 550.373.                                  

                                                                                

7       (c) "Health care corporation" means a health care                           

                                                                                

8   corporation incorporated under the nonprofit health care                    

                                                                                

9   corporation reform act,  Act No. 350 of the Public Acts of 1980,            

                                                                                

10  being sections 550.1101 to 550.1704 of the Michigan Compiled                

                                                                                


                                                                                

1   Laws  1980 PA 350, MCL 550.1101 to 550.1704.                                

                                                                                

2       (d) "Health care provider" means a health facility or a                     

                                                                                

3   person licensed, certified, or registered under parts 61 to 65 or           

                                                                                

4   161 to 182 of the public health code,  Act No. 368 of the Public            

                                                                                

5   Acts of 1978, being sections 333.6101 to 333.6523 and 333.16101             

                                                                                

6   to 333.18237 of the Michigan Compiled Laws  1978 PA 368, MCL                

                                                                                

7   333.6101 to 333.6523 and 333.16101 to 333.18237 However,                 

                                                                                

8   health care provider does not include a pharmacist or pharmacy              

                                                                                

9   engaged in the retail sale of drugs, until January 1, 1987.                 

                                                                                

10      (e) "Health facility" means:                                                

                                                                                

11                                                                               (i) A health facility or agency licensed or authorized under                        

                                                                                

12  parts 201 to 217 of the public health code,  or a licensed part             

                                                                                

13  thereof, except a facility or agency licensed under part 203 of             

                                                                                

14  the public health code  1978 PA 368, MCL 333.20101 to                       

                                                                                

15  333.21799e.                                                                 

                                                                                

16      (ii) A mental hospital, psychiatric hospital, psychiatric                    

                                                                                

17  unit, or mental retardation facility operated by the department             

                                                                                

18  of  mental  community health or certified or licensed under  Act            

                                                                                

19  No. 258 of the Public Acts of 1974, being sections 330.1001 to              

                                                                                

20  330.2106 of the Michigan Compiled Laws  the mental health code,             

                                                                                

21  1974 PA 258, MCL 330.1001 to 330.2106.                                      

                                                                                

22      (iii) A facility providing outpatient physical therapy                       

                                                                                

23  services, including speech pathology services.                              

                                                                                

24      (iv) A kidney disease treatment center, including a                          

                                                                                

25  freestanding hemodialysis unit.                                             

                                                                                

26      (v) An organized ambulatory health care facility.                           

                                                                                

27      (vi) A tertiary health care service facility.                                


                                                                                

1       (vii) A substance abuse treatment program licensed under                     

                                                                                

2   parts 61 to 65 of the public health code,  Act No. 368 of the               

                                                                                

3   Public Acts of 1978, being sections 333.6101 to 333.6523 of the             

                                                                                

4   Michigan Compiled Laws  1978 PA 368, MCL 333.6101 to 333.6523.              

                                                                                

5       (viii) An outpatient psychiatric clinic.                                      

                                                                                

6       (ix) A home health agency.                                                   

                                                                                

7       (f) "Health maintenance organization" means a health                        

                                                                                

8   maintenance organization  licensed under article 17 of the public           

                                                                                

9   health code, Act No. 368 of the Public Acts of 1978, being                  

                                                                                

10  sections 333.20101 to 333.22181 of the Michigan Compiled Laws               

                                                                                

11  operating pursuant to chapter 35 of the insurance code of 1956,             

                                                                                

12  1956 PA 218, MCL 500.3501 to 500.3580.                                      

                                                                                

13      (g) "Hospital service corporation" means a hospital service                 

                                                                                

14  corporation incorporated under Act No. 109 of the Public Acts of            

                                                                                

15  1939, being sections 550.501 to 550.517 of the Michigan Compiled            

                                                                                

16  Laws.                                                                       

                                                                                

17      (g)  (h)  "Insurer" means an insurer as defined in section                  

                                                                                

18  106 of the insurance code of 1956,  Act No. 218 of the Public               

                                                                                

19  Acts of 1956, being section 500.106 of the Michigan Compiled                

                                                                                

20  Laws  1956 PA 218, MCL 500.106.                                             

                                                                                

21      (i) "Medical care corporation" means a medical care                         

                                                                                

22  corporation incorporated under Act No. 108 of the Public Acts of            

                                                                                

23  1939, being sections 550.301 to 550.316 of the Michigan Compiled            

                                                                                

24  Laws.                                                                       

                                                                                

25      (h)  (j)  "Organization" means an insurer, a dental care                    

                                                                                

26  corporation,  hospital service corporation, medical care                    

                                                                                

27  corporation,  health care corporation, pharmacy benefit manager,            


                                                                                

1   or third party administrator.                                               

                                                                                

2       (i) "Pharmacy benefit manager" means a pharmacy benefit                     

                                                                                

3   manager operating under a certificate of authority issued by the            

                                                                                

4   commissioner pursuant to chapter 37 of the insurance code of                

                                                                                

5   1956, 1956 PA 218, MCL 500.3701 to 500.3725.                                

                                                                                

6       (j)  (k)  "Provider panel" means a panel or network of                      

                                                                                

7   health care providers providing health care services pursuant to            

                                                                                

8   a prudent purchaser agreement.                                              

                                                                                

9       (k)  (l)  "Prudent purchaser agreement" means an agreement                  

                                                                                

10  between an organization and a health care provider pursuant to              

                                                                                

11  section 3.                                                                  

                                                                                

12                                                                               (l)  (m)  "Third party administrator" means an administrator                         

                                                                                

13  operating under a certificate of authority issued by the                    

                                                                                

14  commissioner pursuant to the third party administrator act, 1984            

                                                                                

15  PA 218, MCL 550.901 to 550.960.                                             

                                                                                

16      Sec. 3c.  (1) An organization that establishes a provider                   

                                                                                

17  panel of pharmacy providers shall do all of the following:                  

                                                                                

18      (a) Reimburse all pharmacy providers in the panel under the                 

                                                                                

19  same terms for the same strength, quantity, and days' supply of             

                                                                                

20  the same covered prescription drugs, including performance-based            

                                                                                

21  incentives that include movement of market share or generic                 

                                                                                

22  substitution or other actions that result because of an action              

                                                                                

23  taken by a pharmacy provider.                                               

                                                                                

24      (b) Apply the same pricing rules relative to package size                   

                                                                                

25  and national drug code to all pharmacy providers in the panel.              

                                                                                

26      (c) Apply the same dispensing or other service reimbursement                

                                                                                

27  fees and terms to all pharmacy providers in the panel.                      


                                                                                

1       (d) Apply the same co-pay and payment terms regardless of                   

                                                                                

2   which pharmacy provider in the panel dispenses the prescription.            

                                                                                

3       (e) Provide all pharmacy providers in the panel with equal                  

                                                                                

4   access to patient profiles maintained by that organization.                 

                                                                                

5       (f) Maintain the right of a patient to receive a 30-day                     

                                                                                

6   supply of medication, at the same co-pay as mail order or                   

                                                                                

7   internet, if a prescription fails to be received for whatever               

                                                                                

8   reason by a patient on a timely basis.                                      

                                                                                

9       (2) An organization that establishes a provider panel of                    

                                                                                

10  pharmacy providers shall not do any of the following:                       

                                                                                

11      (a) Set a limit on the quantity of drugs or days' supply of                 

                                                                                

12  drugs that will be reimbursed, unless the limit is applied                  

                                                                                

13  uniformly to all pharmacy providers in the panel.                           

                                                                                

14      (b) Require pharmacy providers to agree to participate in                   

                                                                                

15  any other network, contract, or arrangement for pharmacy benefit            

                                                                                

16  services as a condition for participation in any other network,             

                                                                                

17  contract, or arrangement for the provision of pharmacy benefit              

                                                                                

18  services.                                                                   

                                                                                

19      (c) Amend, revise, add, remove, or modify any material                      

                                                                                

20  terms, provisions, or conditions of any contract with a pharmacy            

                                                                                

21  provider, and any accompanying pharmacy service manuals or                  

                                                                                

22  documents, during the term of the pharmacy provider contract                

                                                                                

23  without the express written consent and agreement of the pharmacy           

                                                                                

24  provider.                                                                   

                                                                                

25      (d) Withhold, recoup, or attempt to recoup any funds due to                 

                                                                                

26  a pharmacy provider from an audit through a setoff against future           

                                                                                

27  sums due and owing to a pharmacy provider.                                  


                                                                                

1       (e) Retroactively reverse, deny acknowledgment of                           

                                                                                

2   participant eligibility, or deny or adjust payments of                      

                                                                                

3   adjudicated, accepted for pharmacy claims in more than a                    

                                                                                

4   reasonable amount of time after adjudication, except where the              

                                                                                

5   organization provides evidence that the pharmacy provider                   

                                                                                

6   received duplicate payment, the pharmacy did not provide the                

                                                                                

7   prescription services, or the claim is fraudulent.                          

                                                                                

8       (f) Use patient data, including data derived or gained from                 

                                                                                

9   a pharmacy provider, to market or sell services in competition              

                                                                                

10  with any pharmacy provider on the panel.                                    

                                                                                

11      Sec. 3d.  A pharmacy provider on a provider panel under this                

                                                                                

12  act that provides prescription drugs or devices for residents of            

                                                                                

13  this state shall comply with part 177 of the public health code,            

                                                                                

14  1978 PA 368, MCL 333.17701 to 333.17770.                                    

                                                                                

15      Sec. 3e.  (1) An organization that establishes a provider                   

                                                                                

16  panel of pharmacy providers shall disclose in writing annually on           

                                                                                

17  or before March 1 to the commissioner and to all purchasers of              

                                                                                

18  its coverage all of the following:                                          

                                                                                

19      (a) Any ownership in or economic relationship other than a                  

                                                                                

20  network provider relationship with any pharmacy or provider of              

                                                                                

21  prescription drugs or devices.                                              

                                                                                

22      (b) Any ownership in or economic relationship other than a                  

                                                                                

23  formulary or rebate arrangement with any pharmaceutical                     

                                                                                

24  manufacturer or distributor.                                                

                                                                                

25      (c) Any agreement or practice by the organization to bill a                 

                                                                                

26  benefit plan for prescription drugs, including dispensing fees,             

                                                                                

27  at amounts higher than the organization pays the pharmacy.                  


                                                                                

1       (d) Any agreement to share revenue, other than through a                    

                                                                                

2   provider agreement, with a mail-order or internet pharmacy                  

                                                                                

3   company.                                                                    

                                                                                

4       (e) Any agreement to sell prescription drug data, including                 

                                                                                

5   data as to the prescribing practices of individual health care              

                                                                                

6   providers in the state.                                                     

                                                                                

7       (f) For agreements with pharmaceutical manufacturers that                   

                                                                                

8   involve favoring the manufacturer's products over a competitor's            

                                                                                

9   products or placing the manufacturer's product or products on the           

                                                                                

10  preferred drug list or formulary of the organization or of the              

                                                                                

11  purchaser of coverage:                                                      

                                                                                

12                                                                               (i) The name and food and drug administration labeler code of                       

                                                                                

13  the drug manufacturer.                                                      

                                                                                

14      (ii) The formula or formulas for sharing all revenue                         

                                                                                

15  received, by the organization from the drug manufacturer, between           

                                                                                

16  the organization and the purchaser of coverage.                             

                                                                                

17      (iii) Any fees or other economic considerations to the                       

                                                                                

18  organization from the drug manufacturer that are not shared with            

                                                                                

19  or passed on to the purchaser of coverage.                                  

                                                                                

20      (g) Any timing issue concerning the organization's receipt of               

                                                                                

21  rebates or other economic considerations from the drug                      

                                                                                

22  manufacturers and the time taken to pass the rebates or other               

                                                                                

23  economic considerations on to the purchaser of coverage.                    

                                                                                

24      (2) An organization that establishes a provider panel of                    

                                                                                

25  pharmacy providers shall disclose, if applicable, its ownership             

                                                                                

26  interest in a mail-order or internet pharmacy to a purchaser of             

                                                                                

27  its coverage and to persons who have coverage authorized by this            


                                                                                

1   act.                                                                        

                                                                                

2       (3) An organization that establishes a provider panel of                    

                                                                                

3   pharmacy providers shall disclose to a purchaser of its coverage            

                                                                                

4   its databank source and prices used in its pricing calculations.            

                                                                                

5   This shall include databanks and prices that are not published by           

                                                                                

6   third parties, including, but not limited to, Medispan or First             

                                                                                

7   Data.                                                                       

                                                                                

8       Sec. 3f.  A pharmacy's or pharmacist's affiliation or                       

                                                                                

9   participation in a panel shall not be terminated because of                 

                                                                                

10  efforts by the pharmacy or pharmacist to invoke his or her rights           

                                                                                

11  under the prudent purchaser agreement.                                      

                                                                                

12      Sec. 3g.  An organization that establishes a provider panel                 

                                                                                

13  of pharmacy providers shall electronically notify pharmacy                  

                                                                                

14  providers on the panel of any additions or deletions of                     

                                                                                

15  purchasers of coverage or covered lines or of changes in benefit            

                                                                                

16  design within 30 days of the addition, deletion, or change.                 

                                                                                

17      Enacting section 1.  This amendatory at does not take effect                

                                                                                

18  unless all of the following bills of the 92nd Legislature are               

                                                                                

19  enacted into law:                                                           

                                                                                

20      (a) Senate Bill No. _____ or House Bill No. 5437  (request                  

                                                                                

21  no. 04345'03*).                                                             

                                                                                

22      (b) Senate Bill No. _____ or House Bill No. 5436  (request                  

                                                                                

23  no. 05814'03).                                                              

                                                                                

24      (c) Senate Bill No. _____ or House Bill No. 5435  (request                  

                                                                                

25  no. 05887'03).                                                              

                                                                                

26      (d) House Bill No. 4987.