SENATE BILL No. 594

 

 

June 19, 2003, Introduced by Senator EMERSON and referred to the Committee on Appropriations.

 

 

        

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                

                                                                                 A bill to amend 1978 PA 368, entitled                                             

                                                                                

    "Public health code,"                                                       

                                                                                

    (MCL 333.1101 to 333.25211) by adding section 17744.                        

                                                                                

                THE PEOPLE OF THE STATE OF MICHIGAN ENACT:                      

                                                                                

1       Sec. 17744.  (1) The department of community health shall                   

                                                                                

2   establish a medicaid pharmacy advisory committee for the purpose            

                                                                                

3   of monitoring, evaluating, and providing input to the department            

                                                                                

4   of community health regarding the prescription drug dispensing              

                                                                                

5   assessment plan implemented under this section.  The medicaid               

                                                                                

6   pharmacy advisory committee shall consist of actively practicing            

                                                                                

7   individuals who are representative of all areas of pharmacy                 

                                                                                

8   practice, including, but not limited to, the Michigan pharmacists           

                                                                                

9   association, the Michigan retailers association, and the long               

                                                                                

10  term care pharmacy alliance or their successor organizations.               

                                                                                

11      (2) The department of community health shall assess a                       

                                                                                


                                                                                

1   prescription drug dispensing assessment fee on a quarterly basis            

                                                                                

2   as provided in this section for prescription dispensing                     

                                                                                

3   transactions involving covered outpatient drugs that are                    

                                                                                

4   dispensed by a pharmacy licensed under section 17741 regardless             

                                                                                

5   of the physical location of the pharmacy or the method of                   

                                                                                

6   delivery of the prescription to the individual.  The prescription           

                                                                                

7   drug dispensing assessment fee shall be based on the number of              

                                                                                

8   original and refill prescriptions for covered outpatient drugs              

                                                                                

9   that are dispensed and delivered directly to individuals within             

                                                                                

10  this state.  The prescription drug dispensing assessment fee                

                                                                                

11  shall be based upon the following fee schedule unless otherwise             

                                                                                

12  provided in a general or supplemental appropriations act for the            

                                                                                

13  department of community health enacted after the effective date             

                                                                                

14  of the amendatory act that added this section:                              

                                                                                

15      (a) In accordance with federal law and regulations, the                     

                                                                                

16  prescription drug dispensing assessment fee shall be assessed on            

                                                                                

17  a per prescription fee basis ranging from 4 cents to $3.00 as               

                                                                                

18  determined by the department of community health to assure that             

                                                                                

19  the prescription drug dispensing assessment fee does not disrupt            

                                                                                

20  access to pharmaceuticals or negatively affect the market.                  

                                                                                

21      (b) The medicaid pharmaceutical dispensing fee established                  

                                                                                

22  under 2002 PA 519 shall be increased by $3.30.                              

                                                                                

23      (3) The prescription drug dispensing assessment fee does not                

                                                                                

24  apply to either of the following:                                           

                                                                                

25      (a) A dispensing prescriber who holds a drug control license                

                                                                                

26  and dispenses the prescriptions in accordance with section                  

                                                                                

27  17745.                                                                      


                                                                                

1       (b) A pharmacy that dispenses a prescription without                        

                                                                                

2   receiving reimbursement for either the cost of the drug or the              

                                                                                

3   cost of dispensing the drug.                                                

                                                                                

4       (4) The prescription drug assessment fee collected under                    

                                                                                

5   subsection (2) shall be used only for the following purposes and            

                                                                                

6   under the following circumstances:                                          

                                                                                

7       (a) The prescription drug assessment fee shall be implemented               

                                                                                

8   and assessed on the effective date of the amendatory act that               

                                                                                

9   added this section and on the first day of each subsequent                  

                                                                                

10  quarter.  The first payment is due 90 days after the effective              

                                                                                

11  date of the amendatory act that added this section.                         

                                                                                

12      (b) Except as otherwise provided in this subdivision, the                   

                                                                                

13  department of community health shall no longer assess or collect            

                                                                                

14  the prescription drug assessment fee after September 30, 2006.              

                                                                                

15  If the prescription drug assessment fee or the medicaid                     

                                                                                

16  pharmaceutical dispensing fee established under subsection (2) is           

                                                                                

17  changed by a subsequent general or supplemental appropriations              

                                                                                

18  act for the department of community health, the department of               

                                                                                

19  community health shall cease assessing or collecting the                    

                                                                                

20  prescription drug assessment fee on the effective date of that              

                                                                                

21  subsequent general or supplemental appropriations act and the               

                                                                                

22  medicaid pharmaceutical dispensing fee shall immediately revert             

                                                                                

23  to the amount established under 2002 PA 519 unless specified                

                                                                                

24  otherwise in that appropriations act.                                       

                                                                                

25      (c) If a pharmacy fails to pay the assessment fee required                  

                                                                                

26  under subsection (2) or knowingly misrepresents the data required           

                                                                                

27  under subsection (5), the department of community health may                


                                                                                

1   assess the pharmacy a penalty of 5% of the calculated assessment            

                                                                                

2   for each month that the assessment and penalty are not paid up to           

                                                                                

3   a maximum of 50% of the assessment.  The department of community            

                                                                                

4   health may also refer for collection to the department of                   

                                                                                

5   treasury past due amounts consistent with section 13 of 1941 PA             

                                                                                

6   122, MCL 205.13.                                                            

                                                                                

7       (d) The medicaid prescription drug dispensing assessment fund               

                                                                                

8   is established in the state treasury.  The department of                    

                                                                                

9   community health shall deposit the revenue raised through the               

                                                                                

10  prescription drug dispensing assessment fee with the state                  

                                                                                

11  treasurer for deposit in the medicaid prescription drug                     

                                                                                

12  dispensing assessment fund.                                                 

                                                                                

13      (e) Neither the department of consumer and industry services                

                                                                                

14  nor the department of community health shall implement this                 

                                                                                

15  section in a manner that conflicts with 42 U.S.C. 1396b(w).                 

                                                                                

16      (f) The prescription drug dispensing assessment fee shall be                

                                                                                

17  assessed, collected, and administered in accordance with 1941 PA            

                                                                                

18  122, MCL 205.1 to 205.31.                                                   

                                                                                

19      (g) The increase under subsection (2)(b) shall be used to                   

                                                                                

20  reimburse a pharmacy for the dispensing of covered outpatient               

                                                                                

21  drugs to medicaid recipients enrolled in a health maintenance               

                                                                                

22  organization established under chapter 35 of the insurance code             

                                                                                

23  of 1956, 1956 PA 218, MCL 500.3501 to 500.3580.  The                        

                                                                                

24  reimbursement rate shall be the equivalent of the increase under            

                                                                                

25  subsection (2)(b) times the number of original and refill                   

                                                                                

26  prescriptions for covered outpatient drugs dispensed to a                   

                                                                                

27  medicaid recipient enrolled in a health maintenance                         


                                                                                

1   organization.  If requested by the pharmacy, the department of              

                                                                                

2   community health may offset the assessment fee owed by a pharmacy           

                                                                                

3   against the reimbursement provided for under this subdivision.              

                                                                                

4       (5) By January 15, April 15, July 15, and October 15 of each                

                                                                                

5   year, a pharmacy licensed under section 17741 that dispenses and            

                                                                                

6   delivers original and refill prescriptions for covered outpatient           

                                                                                

7   drugs shall submit a report to the department of community health           

                                                                                

8   on a form developed by the department of community health that              

                                                                                

9   includes each of the following:                                             

                                                                                

10      (a) The name of the pharmacy.                                               

                                                                                

11      (b) The address of the place of practice.                                   

                                                                                

12      (c) The name of the licensed pharmacist or contact person.                  

                                                                                

13      (d) The telephone number of the pharmacy.                                   

                                                                                

14      (e) The pharmacy's federal tax identification number.                       

                                                                                

15      (f) The pharmacy identification number.                                     

                                                                                

16      (g) The number of original and refill prescriptions for                     

                                                                                

17  covered outpatient drugs that were dispensed and delivered within           

                                                                                

18  this state by the pharmacy for the previous calendar quarter.               

                                                                                

19      (6) The department of community health shall determine the                  

                                                                                

20  amount of the prescription drug assessment fee to be assessed               

                                                                                

21  quarterly to each pharmacy based upon the report submitted under            

                                                                                

22  subsection (5) by that pharmacy.                                            

                                                                                

23      (7) As used in this section:                                                

                                                                                

24      (a) "Covered outpatient drug" means that term as defined                    

                                                                                

25  under 42 U.S.C. 1396r-8(k)(2) to (4).                                       

                                                                                

26      (b) "Medicaid" means that term as defined in section 22207.                 

                                                                                

27      Enacting section 1.  This amendatory act does not take                      


                                                                                

1   effect until October 1, 2003 and unless each of the following               

                                                                                

2   conditions is satisfied:                                                    

                                                                                

3       (a) The United States department of health and human services               

                                                                                

4   approves the increase of the pharmaceutical dispensing fee and              

                                                                                

5   does not prohibit the implementation of the prescription drug               

                                                                                

6   assessment fee as established in this amendatory act.                       

                                                                                

7       (b) The secretary of health and human services approves the                 

                                                                                

8   department of community health's application for a waiver of the            

                                                                                

9   uniform fee requirement under 42 U.S.C. 1396b(w).