PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Medical Assistance Administration)
Original Notice.
Preproposal statement of inquiry was filed as WSR 04-03-089.
Title of Rule: WAC 388-530-1850 Drug utilization and education (DUE) council.
Purpose: To change the name of MAA's Drug Utilization and Education (DUE) Council in accordance with C.F.R. and to include language about the Pharmacy and Therapeutics Committee as established by the Health Care Authority.
Statutory Authority for Adoption: RCW 41.05.160, 74.04.050, 74.04.057, and 74.08.090; SB 6088, section 10, chapter 29, Laws of 2003 1st sp.s.
Statute Being Implemented: 42 C.F.R. 456.716.
Summary: The proposed changes:
| • | Rename the program - Drug use review (DUR) board in accordance with 42 C.F.R. 456.716; |
| • | Add language allowing members of the Pharmacy and Therapeutics Committee as established by the 2003 legislature (SB 6088, chapter 29, Laws of 2003) to serve as members of the DUR board (see chapter 182-50 WAC); and |
| • | Add language, in accordance with 42 C.F.R. 456.716, stating that MAA has final authority to "accept" or "reject" the recommendations of the DUR board. |
Reasons Supporting Proposal: These rules are necessary to implement and manage the prescription drug programs established by the 2003 legislature and chapter 41.05 RCW.
Name of Agency Personnel Responsible for Drafting: Wendy Boedigheimer, MAA, P.O. Box 45533, Olympia, WA 98504-5533, (360) 725-1306; Implementation and Enforcement: Siri Childs, MAA, P.O. Box 45506, Olympia, WA 98504-5506, (360) 725-1564.
Name of Proponent: Department of Social and Health Services, governmental.
Rule is necessary because of federal law, 42 C.F.R. 456.716.
Explanation of Rule, its Purpose, and Anticipated Effects: See Purpose, Summary, and Reasons Supporting Proposal above.
Proposal Changes the Following Existing Rules: See Summary and Reasons Supporting Proposal above.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed amendments are exempt from a small business economic impact statement (SBEIS) according to RCW 19.85.025(3) because the proposed changes:
| • | Adopt federal regulations; |
| • | Adopt rules of other Washington state agencies; |
| • | Include housekeeping changes; |
| • | Do not impose additional costs or change reimbursement rates for small businesses, nor do the proposed changes impose new administrative burdens on small business; and |
| • | Do not impose any new regulatory limits on businesses. |
RCW 34.05.328 does not apply to this rule adoption. The proposed amendments are exempt from a cost benefit analysis (CBA) according to RCW 34.05.328 (5)(b) and (c) because the proposed changes:
| • | Adopt federal regulations; |
| • | Adopt rules of other Washington state agencies; and |
| • | Include housekeeping changes. |
Hearing Location: Office Building 2, 16th and Jefferson, Olympia, Washington 98504, on April 27, 2004, at 10:00 a.m.
Assistance for Persons with Disabilities: Contact DSHS Rules Coordinator by April 21, 2004, phone (360) 664-6094, TTY (360) 664-6178, e-mail fernaax@dshs.wa.gov.
Submit Written Comments to: Identify WAC Numbers, DSHS Rules Coordinator, Rules and Policies Assistance Unit, P.O. Box 45850, Olympia, WA 98504-5850, fax (360) 664-6185, e-mail fernaax@dshs.wa.gov, by 5:00 p.m. on April 27, 2004.
Date of Intended Adoption: Not sooner than April 28, 2004.
March 18, 2004
Brian H. Lindgren, Manager
Rules and Policies Assistance Unit
3379.2 (1) The ((DUE council)) DUR board:
(a) ((Has a minimum of eight and a maximum of ten
members, representing)) Includes health professionals who are
actively practicing ((health care professionals)) and licensed
in the state of Washington and who have recognized knowledge
and expertise in one or more of the following:
(i) The clinically appropriate prescribing of covered outpatient drugs;
(ii) The clinically appropriate dispensing and monitoring of covered outpatient drugs;
(iii) Drug use review, evaluation, and intervention; and
(iv) Medical quality assurance((; and
(v) Disease state management)).
(b) Is made up of at least one-third but not more than
fifty-one percent physicians, and at least one-third ((but not
more than fifty-one percent)) pharmacists((; and
(c) Includes an advanced registered nurse practitioner and a physician assistant.
(2) The DUE council)).
(2) MAA may appoint members of the pharmacy and therapeutics committee established by the health care authority (HCA) under chapter 182-50 WAC or other qualified individuals to serve as members of the DUR board.
(3) The DUR board meets periodically to:
(a) Advise MAA on drug utilization review activities;
(b) Review provider and patient profiles;
(c) Recommend adoption of standards and treatment guidelines for drug therapy;
(d) ((Provide)) Recommend interventions targeted toward
correcting drug therapy problems; and
(e) Produce an annual report.
(4) MAA has the authority to accept or reject the recommendations of the DUR board in accordance with 42 C.F.R. 456.716(c).
[Statutory Authority: RCW 74.09.080, 74.04.050 and 42 C.F.R. Subpart K, subsection 162.1102. 02-17-023, § 388-530-1850, filed 8/9/02, effective 9/9/02. Statutory Authority: RCW 74.08.090, 74.04.050. 01-01-028, § 388-530-1850, filed 12/7/00, effective 1/7/01. Statutory Authority: RCW 74.08.090. 96-21-031, § 388-530-1850, filed 10/9/96, effective 11/9/96.]