Bill Text: CA SB619 | 2015-2016 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Pharmacy: outsourcing facilities: licensure.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Failed) 2016-02-01 - Returned to Secretary of Senate pursuant to Joint Rule 56. [SB619 Detail]

Download: California-2015-SB619-Introduced.html

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BILL NUMBER: SB 619	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Morrell
   (Coauthor: Senator Stone)

                        FEBRUARY 27, 2015

   An act to amend Section 14105.455 of the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 619, as introduced, Morrell. Medi-Cal.
   Existing law provides for the Medi-Cal program, which is
administered by the State Department of Health Care Services, under
which qualified low-income individuals receive health care services,
including pharmacy services and drugs. Existing law requires pharmacy
providers to submit their usual and customary charge when billing
the Medi-Cal program for prescribed drugs.
   This bill would make a technical, nonsubstantive change to that
provision.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 14105.455 of the Welfare and Institutions Code
is amended to read:
   14105.455.  (a) Pharmacy providers shall submit their usual and
customary charge when billing the Medi-Cal program for prescribed
drugs.
   (b) "Usual and customary charge" means the lower  of either
 of the following:
   (1) The lowest price reimbursed to the pharmacy by other
third-party payers in California, excluding Medi-Cal managed care
plans and Medicare Part D prescription drug plans.
   (2) The lowest price routinely offered to any segment of the
general public.
   (c) Donations or discounts provided to a charitable organization
are not considered usual and customary charges.
   (d) Pharmacy providers shall keep and maintain records of their
usual and customary charges for a period of three years from the date
the service was rendered.
   (e) Payment to pharmacy providers shall be the lower of the
pharmacy's usual and customary charge or the reimbursement rate
pursuant to subdivision (b) of Section 14105.45.
   (f) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, or make specific this section by
means of a provider bulletin or notice, policy letter, or other
similar instructions, without taking regulatory action.