Bill Text: MN SF1348 | 2011-2012 | 87th Legislature | Introduced
Bill Title: Medication therapy management demonstration pilot project expansion; medication reconciliation demonstration project and task force establishment
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2011-05-02 - Referred to Health and Human Services [SF1348 Detail]
Download: Minnesota-2011-SF1348-Introduced.html
1.2relating to human services; expanding a medication therapy management
1.3demonstration project to provide culturally specific care; establishing a
1.4medication reconciliation demonstration program;amending Minnesota Statutes
1.52010, section 256B.0625, subdivision 13h.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended
1.8to read:
1.9 Subd. 13h. Medication therapy management services. (a) Medical assistance and
1.10general assistance medical care cover medication therapy management services for a
1.11recipient takingfour or more prescriptions to treat or prevent two one or more chronic
1.12medical conditions, or a recipient with a drug therapy problem that is identified or prior
1.13authorized by the commissioner that has resulted or is likely to result in significant
1.14nondrug program costs. The commissioner may cover medical therapy management
1.15services under MinnesotaCare if the commissioner determines this is cost-effective. For
1.16purposes of this subdivision, "medication therapy management" means the provision
1.17of the following pharmaceutical care services by a licensed pharmacist to optimize the
1.18therapeutic outcomes of the patient's medications:
1.19 (1) performing or obtaining necessary assessments of the patient's health status;
1.20 (2) formulating a medication treatment plan;
1.21 (3) monitoring and evaluating the patient's response to therapy, including safety
1.22and effectiveness;
1.23 (4) performing a comprehensive medication review to identify, resolve, and prevent
1.24medication-related problems, including adverse drug events;
2.1 (5) documenting the care delivered and communicating essential information to
2.2the patient's other primary care providers;
2.3 (6) providing verbal education and training designed to enhance patient
2.4understanding and appropriate use of the patient's medications;
2.5 (7) providing information, support services, and resources designed to enhance
2.6patient adherence with the patient's therapeutic regimens; and
2.7 (8) coordinating and integrating medication therapy management services within the
2.8broader health care management services being provided to the patient.
2.9Nothing in this subdivision shall be construed to expand or modify the scope of practice of
2.10the pharmacist as defined in section151.01, subdivision 27 .
2.11 (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
2.12must meet the following requirements:
2.13 (1) have a valid license issued under chapter 151;
2.14 (2) have graduated from an accredited college of pharmacy on or after May 1996, or
2.15completed a structured and comprehensive education program approved by the Board of
2.16Pharmacy and the American Council of Pharmaceutical Education for the provision and
2.17documentation of pharmaceutical care management services that has both clinical and
2.18didactic elements;
2.19 (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
2.20have developed a structured patient care process that is offered in a private or semiprivate
2.21patient care area that is separate from the commercial business that also occurs in the
2.22setting, or in home settings, excluding long-term care and group homes, if the service is
2.23ordered by the provider-directed care coordination team; and
2.24 (4) make use of an electronic patient record system that meets state standards.
2.25 (c) For purposes of reimbursement for medication therapy management services,
2.26the commissioner may enroll individual pharmacists as medical assistance and general
2.27assistance medical care providers. The commissioner may also establish contact
2.28requirements between the pharmacist and recipient, including limiting the number of
2.29reimbursable consultations per recipient.
2.30(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
2.31within a reasonable geographic distance of the patient, a pharmacist who meets the
2.32requirements may provide the services via two-way interactive video. Reimbursement
2.33shall be at the same rates and under the same conditions that would otherwise apply to
2.34the services provided. To qualify for reimbursement under this paragraph, the pharmacist
2.35providing the services must meet the requirements of paragraph (b), and must be located
2.36within an ambulatory care setting approved by the commissioner. The patient must also
3.1be located within an ambulatory care setting approved by the commissioner. Services
3.2provided under this paragraph may not be transmitted into the patient's residence.
3.3(e) The commissioner shall establish a pilot project for an intensive medication
3.4therapy management program for patients identified by the commissioner with multiple
3.5chronic conditions and a high number of medications who are at high risk of preventable
3.6hospitalizations, emergency room use, medication complications, and suboptimal
3.7treatment outcomes due to medication-related problems. For purposes of the pilot
3.8project, medication therapy management services may be provided in a patient's home
3.9or community setting, in addition to other authorized settings. The commissioner may
3.10waive existing payment policies and establish special payment rates for the pilot project.
3.11The pilot project must be designed to produce a net savings to the state compared to the
3.12estimated costs that would otherwise be incurred for similar patients without the program.
3.13The pilot project must begin by January 1, 2010, and end June 30, 2012.
3.14(f) Beginning January 1, 2012, the commissioner of human services shall expand the
3.15pilot project established under paragraph (e) to allow an organization with experience in
3.16providing culturally specific medication therapy management services to American Indian
3.17and other medically underserved communities to contract with pharmacists meeting the
3.18requirements in paragraph (b) to provide medication therapy management services to
3.19enrollees who are American Indian or from underserved communities experiencing health
3.20disparities. The standards and patient eligibility criteria for the original demonstration
3.21project established under paragraph (e) shall otherwise apply, except that the organization
3.22may modify patient eligibility criteria for medication therapy management and may
3.23provide medication therapy management services under this paragraph through June
3.2430, 2014.
3.25 Sec. 2. MEDICATION RECONCILIATION DEMONSTRATION PROJECT.
3.26(a) The commissioner of health shall establish a two-year medication reconciliation
3.27demonstration project to evaluate the quality and effectiveness of various methods
3.28of providing pharmacy-based medication histories, documentation, and medication
3.29reconciliation.
3.30(b) The commissioner shall request proposals from hospitals or health care systems
3.31to implement, beginning January 1, 2012, medication reconciliation projects. The
3.32projects may incorporate innovative practice roles for pharmacists, pharmacy interns,
3.33and pharmacy technicians. Applicants must submit proposals to the commissioner by
3.34September 1, 2011. A proposal must specify the method for providing or compiling
4.1medication histories, documentation, and medication reconciliation, define the duties of
4.2health care professionals, and incorporate an evaluation process.
4.3(c) The commissioner shall establish a medication reconciliation task force to
4.4assist the commissioner in reviewing project applications and working with the hospital
4.5or health system to implement approved projects. The task force shall consist of one
4.6representative from each of the following organizations: the Minnesota Board of
4.7Pharmacy, the Minnesota Hospital Association, the Minnesota Medical Association, the
4.8Minnesota Pharmacists Association, and the Minnesota Society of Hospital Pharmacists.
4.9(d) Hospitals or health care systems implementing a project must submit a
4.10progress report to the commissioner and the medication reconciliation task force by
4.11November 1, 2012, and a final report by December 1, 2013. The task force shall present
4.12recommendations on whether the demonstration project should be continued or expanded
4.13to the commissioner of health, the Minnesota Board of Medical Practice, the Minnesota
4.14Board of Nursing, and the Minnesota Board of Pharmacy by January 15, 2014.
1.3demonstration project to provide culturally specific care; establishing a
1.4medication reconciliation demonstration program;amending Minnesota Statutes
1.52010, section 256B.0625, subdivision 13h.
1.6BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.7 Section 1. Minnesota Statutes 2010, section 256B.0625, subdivision 13h, is amended
1.8to read:
1.9 Subd. 13h. Medication therapy management services. (a) Medical assistance and
1.10general assistance medical care cover medication therapy management services for a
1.11recipient taking
1.12medical conditions, or a recipient with a drug therapy problem that is identified or prior
1.13authorized by the commissioner that has resulted or is likely to result in significant
1.14nondrug program costs. The commissioner may cover medical therapy management
1.15services under MinnesotaCare if the commissioner determines this is cost-effective. For
1.16purposes of this subdivision, "medication therapy management" means the provision
1.17of the following pharmaceutical care services by a licensed pharmacist to optimize the
1.18therapeutic outcomes of the patient's medications:
1.19 (1) performing or obtaining necessary assessments of the patient's health status;
1.20 (2) formulating a medication treatment plan;
1.21 (3) monitoring and evaluating the patient's response to therapy, including safety
1.22and effectiveness;
1.23 (4) performing a comprehensive medication review to identify, resolve, and prevent
1.24medication-related problems, including adverse drug events;
2.1 (5) documenting the care delivered and communicating essential information to
2.2the patient's other primary care providers;
2.3 (6) providing verbal education and training designed to enhance patient
2.4understanding and appropriate use of the patient's medications;
2.5 (7) providing information, support services, and resources designed to enhance
2.6patient adherence with the patient's therapeutic regimens; and
2.7 (8) coordinating and integrating medication therapy management services within the
2.8broader health care management services being provided to the patient.
2.9Nothing in this subdivision shall be construed to expand or modify the scope of practice of
2.10the pharmacist as defined in section
2.11 (b) To be eligible for reimbursement for services under this subdivision, a pharmacist
2.12must meet the following requirements:
2.13 (1) have a valid license issued under chapter 151;
2.14 (2) have graduated from an accredited college of pharmacy on or after May 1996, or
2.15completed a structured and comprehensive education program approved by the Board of
2.16Pharmacy and the American Council of Pharmaceutical Education for the provision and
2.17documentation of pharmaceutical care management services that has both clinical and
2.18didactic elements;
2.19 (3) be practicing in an ambulatory care setting as part of a multidisciplinary team or
2.20have developed a structured patient care process that is offered in a private or semiprivate
2.21patient care area that is separate from the commercial business that also occurs in the
2.22setting, or in home settings, excluding long-term care and group homes, if the service is
2.23ordered by the provider-directed care coordination team; and
2.24 (4) make use of an electronic patient record system that meets state standards.
2.25 (c) For purposes of reimbursement for medication therapy management services,
2.26the commissioner may enroll individual pharmacists as medical assistance and general
2.27assistance medical care providers. The commissioner may also establish contact
2.28requirements between the pharmacist and recipient, including limiting the number of
2.29reimbursable consultations per recipient.
2.30(d) If there are no pharmacists who meet the requirements of paragraph (b) practicing
2.31within a reasonable geographic distance of the patient, a pharmacist who meets the
2.32requirements may provide the services via two-way interactive video. Reimbursement
2.33shall be at the same rates and under the same conditions that would otherwise apply to
2.34the services provided. To qualify for reimbursement under this paragraph, the pharmacist
2.35providing the services must meet the requirements of paragraph (b), and must be located
2.36within an ambulatory care setting approved by the commissioner. The patient must also
3.1be located within an ambulatory care setting approved by the commissioner. Services
3.2provided under this paragraph may not be transmitted into the patient's residence.
3.3(e) The commissioner shall establish a pilot project for an intensive medication
3.4therapy management program for patients identified by the commissioner with multiple
3.5chronic conditions and a high number of medications who are at high risk of preventable
3.6hospitalizations, emergency room use, medication complications, and suboptimal
3.7treatment outcomes due to medication-related problems. For purposes of the pilot
3.8project, medication therapy management services may be provided in a patient's home
3.9or community setting, in addition to other authorized settings. The commissioner may
3.10waive existing payment policies and establish special payment rates for the pilot project.
3.11The pilot project must be designed to produce a net savings to the state compared to the
3.12estimated costs that would otherwise be incurred for similar patients without the program.
3.13The pilot project must begin by January 1, 2010, and end June 30, 2012.
3.14(f) Beginning January 1, 2012, the commissioner of human services shall expand the
3.15pilot project established under paragraph (e) to allow an organization with experience in
3.16providing culturally specific medication therapy management services to American Indian
3.17and other medically underserved communities to contract with pharmacists meeting the
3.18requirements in paragraph (b) to provide medication therapy management services to
3.19enrollees who are American Indian or from underserved communities experiencing health
3.20disparities. The standards and patient eligibility criteria for the original demonstration
3.21project established under paragraph (e) shall otherwise apply, except that the organization
3.22may modify patient eligibility criteria for medication therapy management and may
3.23provide medication therapy management services under this paragraph through June
3.2430, 2014.
3.25 Sec. 2. MEDICATION RECONCILIATION DEMONSTRATION PROJECT.
3.26(a) The commissioner of health shall establish a two-year medication reconciliation
3.27demonstration project to evaluate the quality and effectiveness of various methods
3.28of providing pharmacy-based medication histories, documentation, and medication
3.29reconciliation.
3.30(b) The commissioner shall request proposals from hospitals or health care systems
3.31to implement, beginning January 1, 2012, medication reconciliation projects. The
3.32projects may incorporate innovative practice roles for pharmacists, pharmacy interns,
3.33and pharmacy technicians. Applicants must submit proposals to the commissioner by
3.34September 1, 2011. A proposal must specify the method for providing or compiling
4.1medication histories, documentation, and medication reconciliation, define the duties of
4.2health care professionals, and incorporate an evaluation process.
4.3(c) The commissioner shall establish a medication reconciliation task force to
4.4assist the commissioner in reviewing project applications and working with the hospital
4.5or health system to implement approved projects. The task force shall consist of one
4.6representative from each of the following organizations: the Minnesota Board of
4.7Pharmacy, the Minnesota Hospital Association, the Minnesota Medical Association, the
4.8Minnesota Pharmacists Association, and the Minnesota Society of Hospital Pharmacists.
4.9(d) Hospitals or health care systems implementing a project must submit a
4.10progress report to the commissioner and the medication reconciliation task force by
4.11November 1, 2012, and a final report by December 1, 2013. The task force shall present
4.12recommendations on whether the demonstration project should be continued or expanded
4.13to the commissioner of health, the Minnesota Board of Medical Practice, the Minnesota
4.14Board of Nursing, and the Minnesota Board of Pharmacy by January 15, 2014.
