Bill Text: OR HB2097 | 2011 | Regular Session | Introduced
Bill Title: Relating to medical supplies; declaring an emergency.
Spectrum: Unknown
Status: (Failed) 2011-06-30 - In committee upon adjournment. [HB2097 Detail]
Download: Oregon-2011-HB2097-Introduced.html
76th OREGON LEGISLATIVE ASSEMBLY--2011 Regular Session
NOTE: Matter within { + braces and plus signs + } in an
amended section is new. Matter within { - braces and minus
signs - } is existing law to be omitted. New sections are within
{ + braces and plus signs + } .
LC 658
House Bill 2097
Ordered printed by the Speaker pursuant to House Rule 12.00A (5).
Presession filed (at the request of Governor John A. Kitzhaber
for Oregon Health Authority)
SUMMARY
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.
Expands Oregon Prescription Drug Program to include coverage of
medical supplies necessary for using or administering
prescription drugs.
Declares emergency, effective on passage.
A BILL FOR AN ACT
Relating to medical supplies; amending ORS 414.312, 414.314 and
414.318; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 414.312 is amended to read:
414.312. (1) As used in ORS 414.312 to 414.318:
{ + (a) 'Ancillary medical supplies' means products other
than prescription drugs that are covered under a prescription
drug program with or without a prescription and are necessary for
the use or administration of prescription drugs. + }
{ - (a) - } { + (b) + } 'Pharmacy benefit manager' means an
entity that negotiates and executes contracts with pharmacies,
manages preferred drug lists, negotiates rebates with
{ - prescription drug - } manufacturers { + of prescription
drugs and ancillary medical supplies + } and serves as an
intermediary between the Oregon Prescription Drug Program,
{ - prescription drug - } manufacturers and pharmacies.
{ - (b) - } { + (c) + } 'Prescription drug claims
processor' means an entity that processes and pays
{ - prescription drug - } claims { + for prescription drugs
and ancillary medical supplies + }, adjudicates pharmacy claims,
transmits prescription drug prices and claims data between
pharmacies and the Oregon Prescription Drug Program and processes
related payments to pharmacies.
{ - (c) - } { + (d) + } 'Program price' means the
reimbursement rates and
{ - prescription drug - } prices { + for prescription drugs
and ancillary medical supplies + } established by the
administrator of the Oregon Prescription Drug Program.
(2) The Oregon Prescription Drug Program is established in the
Oregon Health Authority. The purpose of the program is to:
(a) Purchase prescription drugs { + and ancillary medical
supplies + }, replenish { - prescription - } drugs { + and
supplies + } dispensed or reimburse pharmacies for
{ - prescription - } drugs { + and supplies + } in order to
receive discounted prices and rebates;
(b) Make prescription drugs { + and ancillary medical
supplies + } available at the lowest possible cost to
participants in the program as a means to promote health;
(c) Maintain a list of prescription drugs recommended as the
most effective prescription drugs available at the best possible
prices; and
(d) Promote health through the purchase and provision of
discount prescription drugs { + and ancillary medical
supplies + } and coordination of comprehensive prescription
benefit services for eligible entities and members.
(3) The Director of the Oregon Health Authority shall appoint
an administrator of the Oregon Prescription Drug Program. The
administrator may:
(a) Negotiate price discounts and rebates on prescription drugs
{ + and ancillary medical supplies + } with { - prescription
drug - } manufacturers or group purchasing organizations;
(b) Purchase prescription drugs { + and ancillary medical
supplies + } on behalf of individuals and entities that
participate in the program;
(c) Contract with a prescription drug claims processor to
adjudicate pharmacy claims and transmit program prices to
pharmacies;
(d) Determine program prices and reimburse or replenish
pharmacies for prescription drugs { + and ancillary medical
supplies + } dispensed or transferred;
(e) Adopt and implement a preferred drug list for the program;
(f) Develop a system for allocating and distributing the
operational costs of the program and any rebates obtained to
participants of the program; and
(g) Cooperate with other states or regional consortia in the
bulk purchase of prescription drugs { + and ancillary medical
supplies + }.
(4) The following individuals or entities may participate in
the program:
(a) Public Employees' Benefit Board, Oregon Educators Benefit
Board and Public Employees Retirement System;
(b) Local governments as defined in ORS 174.116 and special
government bodies as defined in ORS 174.117 that directly or
indirectly purchase prescription drugs;
(c) Oregon Health and Science University established under ORS
353.020;
(d) State agencies that directly or indirectly purchase
prescription drugs { + and ancillary medical supplies + },
including agencies that dispense prescription drugs { + and
ancillary medical supplies + } directly to persons in
state-operated facilities;
(e) Residents of this state who lack or are underinsured for
prescription drug coverage;
(f) Private entities; and
(g) Labor organizations.
(5) The state agency that receives federal Medicaid funds and
is responsible for implementing the state's medical assistance
program may not participate in the program.
(6) The administrator may establish different program prices
for pharmacies in rural areas to maintain statewide access to the
program.
(7) The administrator may establish the terms and conditions
for a pharmacy to enroll in the program. A licensed pharmacy that
is willing to accept the terms and conditions established by the
administrator may apply to enroll in the program.
(8) Except as provided in subsection { - (10) - }
{ + (9) + } of this section, the administrator may not:
(a) Contract with a pharmacy benefit manager;
(b) Establish a state-managed wholesale or retail drug
distribution or dispensing system; or
(c) Require pharmacies to maintain or allocate separate
inventories for prescription drugs { + or ancillary medical
supplies + } dispensed through the program.
(9) The administrator shall contract with one or more entities
to perform any of the functions of the program, including but not
limited to:
(a) Contracting with a pharmacy benefit manager and directly or
indirectly with such pharmacy networks as the administrator
considers necessary to maintain statewide access to the program.
(b) Negotiating with { - prescription drug - }
manufacturers { + of prescription drugs and ancillary medical
supplies + } on behalf of the administrator.
(10) Notwithstanding subsection (4)(e) of this section,
individuals who are eligible for Medicare Part D prescription
drug coverage may participate in the program.
(11) The program may contract with vendors as necessary to
utilize discount purchasing programs, including but not limited
to group purchasing organizations established to meet the
criteria of the Nonprofit Institutions Act, 15 U.S.C. 13c, or
that are exempt under the Robinson-Patman Act, 15 U.S.C. 13.
SECTION 2. ORS 414.314 is amended to read:
414.314. (1) An individual or entity described in ORS 414.312
(4) may apply to participate in the Oregon Prescription Drug
Program. Participants shall apply on an application provided by
the Oregon Health Authority. The authority may charge
participants a nominal fee to participate in the program. The
authority shall issue a prescription drug identification card to
participants of the program.
(2) The authority shall provide a mechanism to calculate and
transmit the program prices for prescription drugs { + and
ancillary medical supplies + } to a pharmacy. The pharmacy shall
charge the participant the program price for a prescription
drug { + or an ancillary medical supply + }.
(3) A pharmacy may charge the participant the professional
dispensing fee set by the authority.
(4) Prescription drug identification cards issued under this
section must contain the information necessary for proper claims
adjudication or transmission of price data.
SECTION 3. ORS 414.318 is amended to read:
414.318. The Prescription Drug Purchasing Fund is established
separate and distinct from the General Fund. The Prescription
Drug Purchasing Fund shall consist of moneys appropriated to the
fund by the Legislative Assembly and moneys received by the
Oregon Health Authority for the purposes established in this
section in the form of gifts, grants, bequests, endowments or
donations. The moneys in the Prescription Drug Purchasing Fund
are continuously appropriated to the authority and shall be used
to purchase prescription drugs { + and ancillary medical
supplies + }, reimburse pharmacies for prescription drugs { +
and ancillary medical supplies + } and reimburse the authority
for the costs of administering the Oregon Prescription Drug
Program, including contracted services costs, computer costs,
professional dispensing fees paid to retail pharmacies and other
reasonable program costs. Interest earned on the fund shall be
credited to the fund.
SECTION 4. { + This 2011 Act being necessary for the immediate
preservation of the public peace, health and safety, an emergency
is declared to exist, and this 2011 Act takes effect on its
passage. + }
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