Text: HF00733 Text: HF00735 Text: HF00700 - HF00799 Text: HF Index Bills and Amendments: General Index Bill History: General Index
PAG LIN
1 1 Section 1. NEW SECTION. 249A.30 IOWA DRUG UTILIZATION
1 2 REVIEW COMMISSION.
1 3 1. The department shall continue to contract with the peer
1 4 review organization, with which the department held a contract
1 5 to carry out the duties of the drug utilization review
1 6 commission as of June 30, 1999, in order to carry out the
1 7 duties of the commission after that date. The meetings of the
1 8 commission are subject to chapter 21, including the closed
1 9 session provisions which allow the commission to conduct
1 10 closed sessions pursuant to section 21.5 for reasons including
1 11 but not limited to matters of client and provider
1 12 confidentiality. A member of the commission shall not receive
1 13 any gift, as defined in section 68B.2, from a manufacturer or
1 14 agent of a manufacturer of a drug or product which may be
1 15 subject to review by the commission.
1 16 2. The commission shall consist of the following members:
1 17 a. Two physicians licensed pursuant to chapter 148, at
1 18 least one of whom maintains a practice which includes a large
1 19 percentage of patients who are recipients of medical
1 20 assistance, one of whom shall be designated by the Iowa
1 21 medical society and one of whom shall be designated by the
1 22 Iowa academy of family physicians.
1 23 b. One physician of osteopathic medicine and surgery
1 24 licensed pursuant to chapter 150A, who maintains a practice
1 25 which includes a large percentage of patients who are
1 26 recipients of medical assistance, designated by the Iowa
1 27 society of osteopathic medicine.
1 28 c. One academically credentialed pharmacist, designated by
1 29 the Iowa pharmacy association.
1 30 d. One institution-based pharmacist, designated by the
1 31 Iowa pharmacy association.
1 32 e. One community-based pharmacist, designated by the Iowa
1 33 pharmacy association.
1 34 3. The members of the commission shall have knowledge and
1 35 expertise in at least one of the following areas:
2 1 a. Clinically appropriate prescribing of drugs used on an
2 2 outpatient basis which are covered under the medical
2 3 assistance program.
2 4 b. Clinically appropriate dispensing and monitoring of
2 5 drugs used on an outpatient basis which are covered under the
2 6 medical assistance program.
2 7 c. Drug use review, evaluation, and intervention.
2 8 d. Medical quality assurance.
2 9 4. The members of the commission shall serve three-year
2 10 terms and shall not serve more than two consecutive terms.
2 11 The director of human services shall ensure that commission
2 12 membership meets the requirements of sections 69.16 and 69.16A
2 13 with regard to original membership and subsequent membership.
2 14 Vacancies shall be filled by the original designating
2 15 organization and in the manner of the original designation.
2 16 Members of the commission shall receive compensation as
2 17 provided under the contract entered into by the department
2 18 pursuant to subsection 1.
2 19 5. The drug utilization review commission shall make
2 20 recommendations to the council on human services pursuant to
2 21 subsection 6 regarding drugs to be subject to prior
2 22 authorization requirements in compliance with federal laws and
2 23 regulations for federal approval of the department's state
2 24 medical assistance plan.
2 25 6. If the commission recommends a drug for inclusion on
2 26 the list of drugs for which prior authorization is required,
2 27 the commission shall include in its recommendation to the
2 28 council on human services an impact statement concerning the
2 29 anticipated effect of any administrative delay on patient
2 30 care; and the administrative cost to pharmacies, physicians,
2 31 health care facilities, and patients. Drugs recommended by
2 32 the commission for prior authorization shall only be added to
2 33 the listing following adoption by rule by the council on human
2 34 services pursuant to chapter 17A. Six months following
2 35 placement of a drug on the prior authorization list, the
3 1 commission shall conduct a review to determine whether that
3 2 drug should remain on the list.
3 3 7. The department shall, with respect to administering a
3 4 prior authorization program, do all of the following:
3 5 a. Make findings, based on clinical reasons, for placing a
3 6 drug on the prior authorization listing in addition to any
3 7 other consideration including cost savings.
3 8 b. Comply with chapter 17A when adopting rules in adding a
3 9 drug to the prior authorization listing.
3 10 c. Include any recommendations of the drug utilization
3 11 review commission in a notice of intended action under chapter
3 12 17A.
3 13 d. Provide telephone or facsimile approval or denial
3 14 within twenty-four hours of receipt of a prior authorization
3 15 request.
3 16 e. Permit a seventy-two-hour supply of any drug on the
3 17 prior authorization listing to be dispensed in emergencies, as
3 18 defined by rule.
3 19 8. Within the first quarter of the state fiscal year
3 20 beginning July 1, 1999, the drug utilization review commission
3 21 shall conduct a review of all the drugs for which prior
3 22 authorization is required to determine if the drugs should
3 23 remain on the listing and shall report its findings to the
3 24 council on human services and to the general assembly by
3 25 December 1, 1999. The drug utilization review commission
3 26 shall subsequently conduct such an annual review within the
3 27 first quarter of the state fiscal year and shall report its
3 28 findings to the council on human services and to the general
3 29 assembly by October 1 of each fiscal year.
3 30 Sec. 2. RULES RESCINDED. The administrative rules
3 31 relating to the prescription drugs subject to prior
3 32 authorization under the medical assistance program pursuant to
3 33 441 IAC 78.1(2)(a)(3) are rescinded as of September 1, 2000.
3 34 The drug utilization review commission shall make
3 35 recommendations to the department of human services by January
4 1 1, 2000, regarding drugs or classes of drugs to be placed on
4 2 the prior authorization listing.
4 3 Sec. 3. EFFECTIVE DATE. This Act, being deemed of
4 4 immediate importance, takes effect upon enactment.
4 5 HF 734
4 6 pf/jg/25
Text: HF00733 Text: HF00735 Text: HF00700 - HF00799 Text: HF Index Bills and Amendments: General Index Bill History: General Index
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