S-0635.1 _______________________________________________
SENATE BILL 5460
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State of Washington 53rd Legislature 1993 Regular Session
By Senators Wojahn, West, Sheldon and Bauer
Read first time 01/29/93. Referred to Committee on Health & Human Services.
AN ACT Relating to cognitive services and the application of cognitive services to medicaid prescriptions; adding new sections to chapter 74.09 RCW; creating new sections; and declaring an emergency.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec. 1. LEGISLATIVE FINDINGS. The legislature finds that:
(1) The fee paid by the medicaid program under the department of social and health services is discounted from the amount determined by the department of social and health services in their survey of the pharmacies actual cost of operations;
(2) The pharmacies must cost-shift the discounted amount to the cash-paying patients; and
(3) The pharmacists cognitive services have never been considered in the fee formula.
NEW SECTION. Sec. 2. DEFINITIONS. Unless the context clearly requires otherwise, the definitions in this section apply to sections 3 and 4 of this act.
(1) "Cognitive services" means those services provided by a pharmacist to or for a patient or health care practitioner that are judgmental or educational in nature rather than technical or informational.
(2) "Comprehensive pharmacy services" or "comprehensive pharmacy services benefits" means that component of pharmacy practice that entails the direct interaction of the pharmacist with the patient and the prescriber, if necessary, for the purpose of assuring that the patient's drug-related needs are met through the responsible provision of drug therapy or the responsible removal of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life.
NEW SECTION. Sec. 3. COGNITIVE SERVICES FEE RECOGNITION. The pharmacy section of the medicaid division of the department shall incorporate the code designation now established for the identification of the cognitive services and establish an average time-based realistic dollar value for each code. The department may use an advisory committee to assist in the evaluation and establishment of the cognitive services fees. The pharmacy shall indicate the cognitive services delivered and the department shall add the dollar value of those additional services to the standard prescription price for the prescription delivered, in the reimbursement total to the pharmacy.
NEW SECTION. Sec. 4. COGNITIVE SERVICES AUDIT. The medicaid division of the department may audit the pharmacy records for verification that the pharmacy has actually performed the services billed. A discrepancy is subject to legal action under the medicaid fraud statutes and rules.
NEW SECTION. Sec. 5. SEVERABILITY CLAUSE. If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.
NEW SECTION. Sec. 6. CAPTIONS NOT PART OF LAW. Captions a used in this act constitute no part of the law.
NEW SECTION. Sec. 7. CODIFICATION. Sections 2 through 4 of this act are each added to chapter 74.09 RCW.
NEW SECTION. Sec. 8. EMERGENCY CLAUSE. This act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and shall take effect immediately.
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