Senate
Study
Bill
1125
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
STATE
GOVERNMENT
BILL
BY
CHAIRPERSON
DANIELSON)
A
BILL
FOR
An
Act
relating
to
medication
therapy
management,
providing
an
1
appropriation,
and
including
effective
date
provisions.
2
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
3
TLSB
2206SC
(6)
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pf/nh
S.F.
_____
Section
1.
NEW
SECTION
.
8A.440
Medication
therapy
1
management.
2
1.
As
used
in
this
section
unless
the
context
otherwise
3
requires:
4
a.
“Eligible
employee”
means
an
employee
of
the
state,
with
5
the
exception
of
an
employee
of
the
state
board
of
regents
or
6
institutions
under
the
state
board
of
regents,
for
whom
group
7
health
plans
are
established
pursuant
to
chapter
509A
providing
8
for
third-party
payment
or
prepayment
for
health
or
medical
9
expenses.
10
b.
“Medication
therapy
management”
means
a
systematic
11
process
performed
by
a
licensed
pharmacist,
designed
to
12
optimize
therapeutic
outcomes
through
improved
medication
use
13
and
reduced
risk
of
adverse
drug
events,
including
all
of
the
14
following
services:
15
(1)
A
medication
therapy
review
and
in-person
consultation
16
relating
to
all
medications,
vitamins,
and
herbal
supplements
17
currently
being
taken
by
an
eligible
individual.
18
(2)
A
medication
action
plan,
subject
to
the
limitations
19
specified
in
this
section,
communicated
to
the
individual
and
20
the
individual’s
primary
care
physician
or
other
appropriate
21
prescriber
to
address
safety
issues,
inconsistencies,
22
duplicative
therapy,
omissions,
and
medication
costs.
The
23
medication
action
plan
may
include
recommendations
to
the
24
prescriber
for
changes
in
drug
therapy.
25
(3)
Documentation
and
follow-up
to
ensure
consistent
levels
26
of
pharmacy
services
and
positive
outcomes.
27
2.
a.
The
department
shall
amend
the
contract
for
the
28
provision
of
medication
therapy
management
services
as
29
initially
required
pursuant
to
2010
Iowa
Acts,
chapter
1193,
30
section
166,
to
provide
for
the
continuation
of
medication
31
therapy
management
services
for
eligible
employees
who
meet
any
32
of
the
following
criteria:
33
(1)
An
individual
who
takes
four
or
more
prescription
drugs
34
to
treat
or
prevent
two
or
more
chronic
medical
conditions.
35
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(2)
An
individual
with
a
prescription
drug
therapy
problem
1
who
is
identified
by
the
prescribing
physician
or
other
2
appropriate
prescriber,
and
referred
to
a
pharmacist
for
3
medication
therapy
management
services.
4
(3)
An
individual
who
meets
other
criteria
established
by
5
the
third-party
payment
provider
contract,
policy,
or
plan.
6
b.
The
contract
shall
require
the
entity
to
provide
annual
7
reports
to
the
general
assembly
detailing
the
costs,
savings,
8
estimated
cost
avoidance
and
return
on
investment,
and
patient
9
outcomes
related
to
the
medication
therapy
management
services
10
provided.
The
entity
shall
guarantee
demonstrated
annual
11
savings,
including
any
savings
associated
with
cost
avoidance
12
at
least
equal
to
the
program’s
costs
with
any
shortfall
amount
13
refunded
to
the
state.
The
contract
shall
include
terms,
14
conditions,
and
applicable
measurement
standards
associated
15
with
the
demonstration
of
savings.
The
department
shall
verify
16
the
demonstrated
savings
reported
by
the
entity
was
achieved
17
in
accordance
with
the
agreed
upon
measurement
standards.
The
18
entity
shall
be
prohibited
from
using
the
entity’s
employees
to
19
provide
the
medication
therapy
management
services
and
shall
20
instead
be
required
to
contract
with
licensed
pharmacies,
21
pharmacists,
or
physicians.
22
c.
The
department
may
establish
an
advisory
committee
23
comprised
of
an
equal
number
of
physicians
and
pharmacists
24
to
provide
advice
and
oversight
in
evaluating
the
results
of
25
the
program.
The
department
shall
appoint
the
members
of
the
26
advisory
committee
based
upon
designees
of
the
Iowa
pharmacy
27
association,
the
Iowa
medical
society,
and
the
Iowa
osteopathic
28
medical
association.
29
d.
The
fees
for
pharmacist-delivered
medication
therapy
30
management
services
shall
be
separate
from
the
reimbursement
31
for
prescription
drug
product
or
dispensing
services;
shall
32
be
determined
by
each
third-party
payment
provider
contract,
33
policy,
or
plan;
and
must
be
reasonable
based
on
the
resources
34
and
time
required
to
provide
the
service.
35
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e.
A
fee
shall
be
established
for
physician
reimbursement
1
for
services
delivered
for
medication
therapy
management
as
2
determined
by
each
third-party
payment
provider
contract,
3
policy,
or
plan,
and
must
be
reasonable
based
on
the
resources
4
and
time
required
to
provide
the
service.
5
f.
If
any
part
of
the
medication
therapy
management
6
plan
developed
by
a
pharmacist
incorporates
services
which
7
are
outside
the
pharmacist’s
independent
scope
of
practice
8
including
the
initiation
of
therapy,
modification
of
dosages,
9
therapeutic
interchange,
or
changes
in
drug
therapy,
the
10
express
authorization
of
the
individual’s
physician
or
other
11
appropriate
prescriber
is
required.
12
Sec.
2.
APPROPRIATION
——
DEPARTMENT
OF
ADMINISTRATIVE
13
SERVICES.
There
is
appropriated
from
the
general
fund
of
the
14
state
to
the
department
of
administrative
services
for
the
15
fiscal
year
beginning
July
1,
2011,
and
ending
June
30,
2012,
16
the
following
amount
or
so
much
thereof
as
is
necessary,
to
be
17
used
for
the
purpose
specified:
18
For
the
medication
therapy
management
program
as
enacted
in
19
this
Act:
20
.
.
.
.
.
.
.
.
.
.
.
.
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.
.
$
481,000
21
Sec.
3.
REPEAL.
2010
Iowa
Acts,
chapter
1193,
section
166,
22
is
repealed.
23
Sec.
4.
EFFECTIVE
UPON
ENACTMENT.
This
Act,
being
deemed
of
24
immediate
importance,
takes
effect
upon
enactment.
25
EXPLANATION
26
This
bill
relates
to
medication
therapy
management.
The
27
bill
codifies
the
pilot
program
for
medication
therapy
28
management
implemented
on
July
1,
2010,
for
eligible
state
29
employees,
making
the
program
an
ongoing
program
and
directing
30
the
department
of
administrative
services
to
amend
the
31
existing
contract
to
continue
the
program
beyond
the
original
32
pilot
program
repeal
date
of
December
31,
2011.
The
bill
33
appropriates
funds
to
the
department
of
administrative
services
34
for
the
purpose
of
the
program.
The
bill
takes
effect
upon
35
-3-
LSB
2206SC
(6)
84
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4
S.F.
_____
enactment.
1
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2206SC
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pf/nh
4/
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