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House Journal: Page 1461: Tuesday, April 11, 1995

30   the chairpersons and ranking members of the joint
31   human services appropriations committee, and to the
32   legislative fiscal bureau.  The study shall address
33   and include information and recommendations regarding
34   all of the following:
35     (a)  A comparison of the costs associated with the
36   prescribing of generic drugs rather than brand name
37   drugs, taking into consideration any rebates or other
38   cost reductions associated with the use of brand name
39   drugs.
40     (b)  A review of the time associated with the prior
41   authorization process including telephone
42   communications between providers and the department's
43   prior authorization fiscal agent and with delays for
44   either party.  The review shall include an analysis of
45   the average time associated with each inquiry by
46   classification of drug.
47     (c)  A review of the number of denials of
48   authorization by classification of drug by the fiscal
49   agent and the rationale for the denials.
50     (d)  A review of the actual and projected cost

Page 2  

 1   savings and workability of the prior authorization
 2   program.
 3     (e)  A review of the services provided by the
 4   fiscal agent including a comparison of the services of
 5   the fiscal agent with private pay insurers in
 6   providing a similar service, and an evaluation of the
 7   current availability of the fiscal agent and any
 8   improvements to the program which might result from
 9   increased availability.
10     (f)  A review of the volume of inquiries for prior
11   authorization during a weekly period including an
12   analysis of the days and times of peak volume as
13   compared with the availability of the fiscal agent for
14   responding to inquiries.
15     (g)  An analysis of the time which elapses between
16   the submission of a bill to the department for
17   reimbursement and actual reimbursement.
18     (2)  Following receipt of the report from the
19   department, the legislative fiscal bureau shall review
20   the study.  The review shall include all of the
21   following:
22     (a)  An evaluation of the cost and savings
23   methodology utilized by the department, including an
24   analysis of whether all governmental costs and savings
25   were included or adequately addressed in the savings
26   methodology used during fiscal year 1994-1995.  If the
27   legislative fiscal bureau determines that the cost and
28   savings methodology utilized by the department or the
29   fiscal agent did not include or adequately address all
30   governmental costs, the legislative fiscal bureau
31   shall provide recommendations to the general assembly

Iowa General Assembly

Index: House Journal (76th General Assembly: Session 1)

© 1995 Cornell College and League of Women Voters of Iowa

Comments? hjourn@legis.iowa.gov.

Last update: Sun Jan 14 21:05:02 CST 1996
URL: /DOCS/GA/76GA/Session.1/HJournal/01400/01461.html
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