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House Journal: Page 1462: Tuesday, April 11, 1995

32   to improve the cost and savings methodology for future
33   application.
34     (b)  An individualized assessment of the prior
35   authorization program based on a random sample of not
36   more than 50 individual prior authorization actions,
37   of which one-half shall be approval actions and one-
38   half shall be denial actions.  The random sample shall
39   be provided by the department to the legislative
40   fiscal bureau based upon a random sampling methodology
41   submitted by the legislative fiscal bureau.  All data
42   deemed necessary by the legislative fiscal bureau to
43   conduct the assessment shall be provided by the
44   department including but not limited to the date and
45   time of the prior authorization contact between the
46   fiscal agent and the provider; the name, address, and
47   telephone number of the provider; and the
48   classification of the drug for which prior
49   authorization was sought.  If the action was an
50   approval action, the department shall provide a

Page   3

 1   statement of the actual cost associated with the
 2   substituted drug and the cost associated with the
 3   alternative drug.  If the action was a denial action,
 4   the department shall provide the rationale for the
 5   denial."
 6     3.  Page 1, by striking lines 26 through 29.
 7     4.  Page 1, by striking lines 30 through 38 and
 8   inserting the following:
 9     "   .  The department shall develop a plan to
10   administratively pursue reimbursement for pharmacy
11   services for which a recipient of medical assistance
12   also has third-party coverage.  The department shall
13   develop the plan in cooperation with the insurance
14   division of the department of commerce and with
15   representatives of the Iowa pharmacists association.
16   The department shall submit the plan to the general
17   assembly on or before January 1, 1996, and shall
18   implement the plan on or before May 1, 1996.  The
19   department shall also include a preliminary estimate
20   of the costs of administratively pursuing
21   reimbursement for pharmacy services in the budget
22   submitted to the council of human services for fiscal
23   year 1996-1997."
24     5.  By relettering as necessary.
Amendment H-3860 was adopted.
Houser of Pottawattamie offered the following amendment H-3853,
to the committee amendment H-3765, filed by him from the floor
and moved its adoption:
H-3853
 1     Amend the amendment, H-3765, to Senate File 462, as

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/01400/01462.html
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