H. B. 3101
(By Delegate Staton)
[Introduced February 21, 2003; referred to the
Committee on Health and Human Resources then Finance.]
A BILL to amend and reenact section fifteen, article five, chapter
nine of the code of West Virginia, one thousand nine hundred
thirty-one, as amended, relating to coverage of prescription
drugs classified as atypical anti-psychotic medications for
patients at risk of hospitalization for mental illness,
medications to treat Alzheimer's disease, and anti-retroviral
medications used to treat the AIDS virus.
Be it enacted by the Legislature of West Virginia:
That section fifteen, article five, chapter nine of the code
of West Virginia, one thousand nine hundred thirty-one, as amended,
be amended and reenacted to read as follows:
ARTICLE 5. MISCELLANEOUS PROVISIONS.
§9-5-15. Medicaid program; preferred drug list and drug
utilization review
.
The Legislature finds that it is a public necessity that trade secrets, rebate amounts, percentage of rebate, manufacturer's
pricing and supplemental rebates that are contained in records, as
well as any meetings at which this information is negotiated or
discussed need confidentiality to insure the most significant
rebates available for the state. Information pertaining to similar
agreements with the federal government and negotiated by
pharmaceutical manufacturers is confidential pursuant to 42 U.S.C.
1396r-8. A rebate as a percentage of average manufacture price is
confidential under federal law and the federal rebate could be made
known if not protected by state law. Because of the protection
afforded by federal law, if this information is not protected by
state law, manufacturers will not be willing to offer a rebate in
West Virginia. Further, the Legislature finds that the number and
value of supplemental rebates obtained by the department will
increase, to the benefit of medicaid recipients, if information
related to the supplemental rebates is protected in the records of
the department and in meetings in which this information is
disclosed because manufactures
The secretary of the department of health and human resources
has the authority to develop a preferred drug list, in accordance
with federal law, which shall consist of federally approved drugs:
Provided, That all drugs in the following therapeutical classes, atypical anti-psychotic medications, medications to treat
Alzheimer's disease, and anti-retroviral medications used to treat
the AIDS virus, shall automatically be available on the preferred
drug list and be exempt from prior authorization and manufacturer
supplemental rebate negotiations. The department, through
administration of the medicaid program, may reimburse, where
applicable and in accordance with federal law, entities providing
and dispensing prescription drugs from the preferred drug list.
The secretary of the department is hereby authorized to
negotiate and enter into agreements with pharmaceutical
manufacturers for supplemental rebates for medicaid reimbursable
drugs.
The provisions of article three, chapter five-a of this code
shall not apply to any contract or contracts entered into under
this section.
Trade secrets, rebate amounts, percentage of rebate,
manufacturer's pricing and supplemental rebates which are contained
in the department's records and those of its agents with respect to
supplemental rebate negotiations and which are prepared pursuant to
a supplemental rebate agreement are confidential and exempt from
all of article one, chapter twenty-nine-b of this code.
Those portions of any meetings of the committee at which trade
secrets, rebate amounts, percentage of rebate, manufacturer's
pricing and supplemental rebates are disclosed for discussion or negotiation of a supplemental rebate agreement are exempt from all
of article nine-a, chapter six of this code.
The secretary of the department will monitor and evaluate the
effects of this provision on medicaid recipients, the medicaid
program, physicians and pharmacies.
The commissioner shall implement a drug utilization review
program to assure that prescribing and dispensing of drug products
result in the most rational cost-effective medication therapy for
medicaid patients.
Any moneys received in supplemental rebates will be deposited
in the medical services fund established in section two, article
four, chapter nine of this code.
NOTE: The purpose of this bill is to exempt from requirements
of the Medicaid preferred drug list certain patients who have a
high risk of hospitalization or institutionalization without
appropriate medication.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.