HB 60 -- Missouri Rx Card Program

Sponsor:  Johnson (47)

This bill establishes the Missouri Rx Card Program as the state
pharmaceutical assistance program in the Department of Social
Services.

The bill:

(1)  Requires the program to provide discounts to eligible
participants for drugs covered through a negotiated rebate
agreement;

(2)  Requires the department to use moneys from the negotiated
rebates to contract with wholesalers and participating retail
pharmacies in order to provide discounted drug prices to eligible
participants;

(3)  Requires the director of the department to calculate drug
discounts received by the program on a quarterly basis;

(4)  Establishes eligibility criteria for participants in the
program.  Missouri residents who are eligible to participate in
Medicare or who have a net family income below 300% of the
federal poverty level are eligible to participate in the program;

(5)  Requires the department to establish enrollment procedures
and to implement outreach efforts to raise awareness of the
program;

(6)  Requires the department to solicit proposals and to select a
responsive, cost-effective bid for the third party administration
of the program.  If no responsive, cost-effective bids are
received, the program will be administered by the department;

(7)  Requires the director to negotiate discount prices or
rebates for prescription drugs from manufacturers and labelers.
A drug manufacturer or labeler that sells prescription drugs in
Missouri may voluntarily elect to negotiate rebates or discount
prices for the program or negotiate discount prices or rebates
for other state programs that pay for or acquire prescription
drugs;

(8)  Requires the director to initiate a review to determine
whether to place a manufacturer's or labeler's products on the
prior authorization list for the Medicaid Program.  The director
can also initiate similar actions involving prior authorizations
or formularies for other state-funded or state-operated
prescription drug programs;

(9)  Authorizes the department to require prior authorization of
pharmaceutical products based on stated criteria;

(10)  Requires that the names of drug manufacturers and labelers
who do not enter into the rebate agreements are public
information;

(11)  Requires the department to establish rules that require
participating retail pharmacies to disclose to program
participants the amount of savings resulting from the program;

(12)  Prohibits the department from imposing transaction charges
on wholesalers or participating retail pharmacies that submit
claims or receive payments under the program;

(13)  Requires participating retail pharmacies to be reimbursed
by the department on a bimonthly basis, including a dispensing
fee not to exceed 75% of the Medicaid dispensing fee;

(14)  Requires the department to report enrollment and financial
data about the program to the General Assembly by February 1 of
each year;

(15)  Allows the director to combine drug pricing negotiations to
maximize drug rebates;

(16)  Grants rule-making authority to the department to implement
the program and allows the department to seek waivers to
implement the program; and

(17)  Requires the discounts for participants to begin July 1,
2005.

The bill contains an emergency clause.

Missouri House of Representatives
93rd General Assembly, 1st Regular Session
Last Updated August 25, 2005 at 1:18 pm