H‑0650.2   _____________________________________________

 

HOUSE BILL 1652

 

           _____________________________________________

 

State of Washington      57th Legislature     2001 Regular Session

 

By Representatives Cody, Campbell, Edmonds and Edwards

 

Read first time 01/31/2001.  Referred to Committee on Health Care.

_1      AN ACT Relating to development of a therapeutic and cost-

_2  effective prescription drug education and utilization system;

_3  adding new sections to chapter 41.05 RCW; adding a new section to

_4  chapter 74.09 RCW; creating a new section; making an

_5  appropriation; providing an effective date; and declaring an

_6  emergency.

     

_7  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

     

_8      NEW SECTION.  Sec. 1.  A new section is added to chapter 41.05

_9  RCW to read as follows:

10      (1) The administrator shall develop, in consultation with state

11  and local agencies and private parties, a therapeutic and cost-

12  effective prescription drug education and utilization system

13  designed to promote therapeutic and cost-effective utilization of

14  prescription drugs by residents of the state of Washington.

15      (2) In developing the system, the administrator shall request

16  the participation of the department of social and health services,

17  the department of health, the department of corrections, the

18  department of labor and industries, the office of the insurance

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_1  commissioner, physicians, advanced registered nurse practitioners,

_2  hospitals, pharmacists, the board of pharmacy, and any other

_3  appropriate licensing boards, consumer representatives, health

_4  plans as defined in RCW 48.43.005, pharmacy benefits management

_5  companies, self-insured employer sponsored health benefits plans,

_6  and any other interested party.

_7      (3) The administrator is authorized to solicit, accept, and

_8  spend public and private grants, contributions, and other funds to

_9  match public funds appropriated to carry out the purposes of this

10  section.

11      (4) The system must include, but is not limited to:

12      (a) The development of a uniform formulary of prescription

13  drugs for state purchased health care, except care purchased or

14  reimbursed by the medicaid program under Title XIX of the federal

15  social security act and local school districts not enrolled in the

16  public employees' benefits board system.  The formulary developed by

17  the administrator under this subsection must be based upon careful

18  consideration and pharmacoeconomic analysis of the clinical

19  efficacy and cost of prescription drugs that have been approved by

20  the federal food and drug administration.  It must contain standards

21  and procedures for consumer access to medically necessary

22  alternatives to the formulary, and for consumer choice of higher

23  cost alternatives to the formulary where a state purchased health

24  care program has the ability to charge higher cost-sharing amounts

25  for nonformulary prescription drugs.  Any other public or private

26  entity may choose to adopt the formulary developed under this

27  subsection;

28      (b) A program of academic detailing and consumer counter-

29  detailing that educates physicians and other prescribers and

30  consumers on the therapeutic and cost-effective utilization of

31  prescription drugs.  In developing this program, the administrator

32  shall first assess current private and public sector academic

33  detailing and consumer counter-detailing activities in Washington

34  state.  The program developed under this subsection should be

35  designed to complement, coordinate, and strengthen these existing

36  activities;

37      (c) Recommendations for continuing medical education

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_1  opportunities and requirements for physicians and other health

_2  care professionals who prescribe, dispense, or administer

_3  prescription drugs;

_4      (d) A program for drug utilization review and drug utilization

_5  management, including prospective, concurrent, and retrospective

_6  review, to improve the quality of pharmaceutical care by ensuring

_7  that prescriptions provided through state-purchased health care

_8  programs are appropriate, medically necessary, and not likely to

_9  produce adverse medical results; and

10      (e) Any other program or activity designed to ensure optimal

11  therapeutic and cost-effective utilization of prescription drugs

12  by consumers.

     

13      NEW SECTION.  Sec. 2.  By January 1, 2002, the administrator of

14  the health care authority shall submit to the governor and the

15  legislature a progress report regarding the implementation of the

16  therapeutic and cost-effective prescription drug education and

17  utilization system.

     

18      NEW SECTION.  Sec. 3.  A new section is added to chapter 41.05

19  RCW to read as follows:

20      The administrator shall design and implement at least two, but

21  no more than five, pilot disease management programs for persons

22  enrolled in the public employees' benefits board uniform medical

23  plan.  The programs shall begin operation on or before July 1, 2002.

24      (1) The administrator shall determine the disease groups most

25  appropriate for disease management after reviewing claims and cost

26  information for uniform medical plan enrollees and reviewing

27  national research on the effectiveness of disease management

28  programs.

29      (2) Each pilot disease management program must include

30  physicians, pharmacists, and other appropriate health care

31  providers in the design and implementation of the program.  The

32  programs also must incorporate an evaluation component that will

33  allow the administrator to identify successful programs that are

34  candidates for statewide expansion.  The evaluation should consider

35  the impact of the disease management program upon the health

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_1  status of participating uniform medical plan enrollees, the use of

_2  health services by these enrollees, and the overall costs of

_3  treating these enrollees.

_4      (3) In designing and implementing the pilot disease management

_5  programs, the administrator shall coordinate with the department

_6  of social and health services' efforts under section 4 of this

_7  act.

     

_8      NEW SECTION.  Sec. 4.  A new section is added to chapter 74.09

_9  RCW to read as follows:

10      The department shall design and implement at least two, but no

11  more than five, pilot disease management programs for aged or

12  disabled persons enrolled in the medical assistance program.  The

13  programs shall begin operation on or before July 1, 2002.

14      (1) The following disease groups must be targeted for disease

15  management programs:  Asthma, diabetes, heart failure, malignancies,

16  obesity, hemophilia, renal disease, transplants, intervertebral

17  disc disorders, and populations at highest risk of improper use of

18  medication.

19      (2) Each pilot disease management program must include

20  physicians, pharmacists, and other appropriate health care

21  providers in the design and implementation of the program.  The

22  programs also must incorporate an evaluation component that will

23  allow the department to identify successful programs that are

24  candidates for statewide expansion.  The evaluation should consider

25  the impact of the disease management program upon the health

26  status of the medicaid enrollee, the use of health services by the

27  enrollee, and the overall costs of treating the enrollee.

28      (3) In designing and implementing the pilot disease management

29  programs, the department shall coordinate with the health care

30  authority's efforts under section 3 of this act.

     

31      NEW SECTION.  Sec. 5.  The sum of one hundred thousand dollars,

32  or as much thereof as may be necessary, is appropriated for the

33  biennium ending June 30, 2003, from the health services account to

34  the health care authority for the purposes of sections 1 and 2 of

35  this act.

36 

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_1      NEW SECTION.  Sec. 6.  This act is necessary for the immediate

_2  preservation of the public peace, health, or safety, or support of

_3  the state government and its existing public institutions, and

_4  takes effect July 1, 2001.

 

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