HB 37 -- Missouri Rx Card Program

Co-Sponsors:  Johnson (47), Salva

This bill establishes the Missouri Rx Card Program as the state
pharmaceutical assistance program in the Department of Social
Services.

The bill:

(1)  Requires the program to provide discounts to eligible
participants for drugs covered through a negotiated rebate
agreement;

(2)  Requires the department to use moneys from the negotiated
rebates to contract with wholesalers and participating retail
pharmacies in order to provide discounted drug prices to eligible
participants;

(3)  Requires the director of the department to calculate drug
discounts received by the program on a quarterly basis;

(4)  Establishes eligibility criteria for participants in the
program.  Missouri residents who are eligible to participate in
Medicare or who have a net family income below 300% of the
federal poverty level are eligible to participate in the program;

(5)  Requires the department to establish enrollment procedures
and to implement outreach efforts to raise awareness of the
program;

(6)  Requires the director to negotiate discount prices or
rebates for prescription drugs from manufacturers and labelers.
A drug manufacturer or labeler that sells prescription drugs in
Missouri may voluntarily elect to negotiate supplemental rebates,
discount prices, or rebates;

(7)  Requires the director to initiate a review to determine
whether to place a manufacturer's or labeler's products on the
prior authorization list for the Medicaid Program.  The director
can also initiate similar actions involving prior authorizations
or formularies for other state-funded or state-operated
prescription drug programs;

(8)  Requires that the names of drug manufacturers and labelers
who do not enter into the rebate agreements are public
information;

(9)  Requires the department to establish rules that require
participating retail pharmacies to disclose to program
participants the amount of savings resulting from the program;

(10)  Requires participating retail pharmacies to verify to the
department the amount charged to program participants and
non-participants and to provide to the department utilization
data necessary to calculate rebates from manufacturers and
labelers.  The department is required to protect the
confidentiality of the information;

(11)  Prohibits the department from imposing transaction charges
on wholesalers or participating retail pharmacies that submit
claims or receive payments under the program;

(12)  Requires wholesalers and participating retail pharmacies to
be paid in advance for program discounts or be reimbursed by the
department on a weekly basis;

(13)  Allows the department to require a wholesaler or a
participating retail pharmacy to segregate drugs used in the
program from other drug inventories;

(14)  Establishes a process for adjudicating disputes or
discrepancies in rebate amounts;

(15)  Requires the department to report enrollment and financial
data about the program and supplemental Medicaid rebate savings
to the General Assembly by February 1 of each year;

(16)  Allows the director to combine drug pricing negotiations to
maximize drug rebates;

(17)  Grants rule-making authority to the department to implement
the program and allows the department to seek waivers to
implement the program; and

(18)  Requires the program to become effective July 1, 2003.
Discounts for participants will begin January 1, 2004.

The bill contains an emergency clause and will become effective
on the later of July 1, 2003, or approval by the Governor.

Missouri House of Representatives
Last Updated July 25, 2003 at 10:10 am