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S. 493
STATUS INFORMATION
General Bill
Sponsors: Senator Thomas
Document Path: l:\s-res\dlt\006pres.mrh.doc
Companion/Similar bill(s): 1053
Introduced in the Senate on March 18, 2003
Currently residing in the Senate Committee on Medical Affairs
Summary: Pharmacy and Therapeutic Committee established in HHS Dept., provisions
HISTORY OF LEGISLATIVE ACTIONS
Date Body Action Description with journal page number ------------------------------------------------------------------------------- 3/18/2003 Senate Introduced and read first time SJ-9 3/18/2003 Senate Referred to Committee on Medical Affairs SJ-9
View the latest legislative information at the LPITS web site
VERSIONS OF THIS BILL
TO AMEND TITLE 44 OF THE 1976 CODE BY ADDING CHAPTER 131 TO ESTABLISH THE PHARMACY AND THERAPEUTICS COMMITTEE WITHIN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, TO PROVIDE FOR THE MEMBERSHIP, ORGANIZATION, AND DUTIES OF THE COMMITTEE, AND TO PROVIDE THAT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES SHALL ADHERE TO CERTAIN PROVISIONS WHEN IMPLEMENTING THE PREFERRED DRUG LIST.
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Title 44 of the 1976 Code is amended by adding:
Section 44-131-10. For purposes of this chapter:
(1) 'Committee' means the Pharmacy and Therapeutics Committee.
(1) 'Department' means the Department of Health and Human Services.
(2) 'Director' means the Director of the Department of Health and Human Services.
Section 44-131-20. (A) There is established within the department the Pharmacy and Therapeutics Committee. The committee shall consist of twelve members appointed by the director. The members shall include:
(1) six physicians licensed in this State and actively engaged in the practice of medicine;
(2) three pharmacists licensed in this State and actively engaged in the practice of pharmacy;
(3) one person representing medical assistance beneficiaries in this State;
(4) one person representing the pharmaceutical industry who is a resident of this State, chosen from a list of nominees provided by the Pharmaceutical Research and Manufacturers of America; and
(5) one person representing mental health patient advocacy groups.
(B) Committee members shall serve three-year terms, except that the director shall appoint two physicians, one pharmacist, and the person representing medical assistance beneficiaries for initial terms of two-year terms, and two physicians, one pharmacist, and the industry representative for initial terms of one year. Members may be reappointed for two additional terms after initial appointment to the committee. A vacancy on the committee shall be filled in same manner as original appointment for the balance of the unexpired term. Committee members shall elect a chairman and a vice chairman on an annual basis from the committee membership.
(C) The committee shall meet at least quarterly and may meet at other times at the discretion of the chairman. The department shall publish notice of any meeting at least thirty days before the meeting. Committee meetings shall comply with the provisions of the Freedom of Information Act and shall be subject to the provisions of the Administrative Procedures Act. The committee shall provide for public comment, including comment on clinical and patient care data.
(D) The committee shall recommend to the department:
(1) therapeutic classes of drugs that should be subject to the Preferred Drug List program and prior authorization requirements;
(2) guidelines to determine whether a drug should be included on the Preferred Drug List to include clinical effectiveness, physician impact, hospital and other costs, and safety profile; and
(3) specific drugs within each therapeutic class to be included on the Preferred Drug List.
Section 44-131-30. The department shall adhere to the following provisions when implementing the Preferred Drug List:
(A) Individuals taking medications covered by Medicaid at the time of adoption of the Preferred Drug List shall not be required to change their medications or obtain prior authorization to continue to receive the same medications under the Medicaid program.
(B) The Preferred Drug List shall include more than one drug in each therapeutic class.
(C) Medications used to treat diabetes, cancer, hemophilia, acquired immune deficiency syndrome, and mental illnesses including, but not limited to, dementia, schizophrenia, depression, and bipolar disorder shall not be subject to any coverage restrictions.
(D) If necessary in an emergency, a seventy-two hour supply of the prescribed drug shall be covered without restriction and a dispensing fee shall be paid to the pharmacy for such supply.
(E) The department shall provide consumer and provider education, training, and information regarding the clinical effectiveness of all prescription drugs, and ongoing communications shall include computer access to information and multilingual material.
(F) Any coverage decisions must be made within twenty-four hours. The recipient and the prescribing physician shall receive notices of any delays or negative decisions and have access to an expedited review of denials by the department.
(G) The department shall develop a grievance mechanism for the patient or the patient's prescriber to appeal a decision to deny access to a drug in the Medicaid program, including an administrative hearing before the department."
SECTION 2. This act takes effect upon approval by the Governor.
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