2012 -- H 7650

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LC01727

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2012

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A N A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

     

     

     Introduced By: Representative Arthur J. Corvese

     Date Introduced: February 16, 2012

     Referred To: House Health, Education & Welfare

It is enacted by the General Assembly as follows:

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     SECTION 1. Section 40-8-24 of the General Laws in Chapter 40-8 entitled "Medical

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Assistance" is hereby amended to read as follows:

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     40-8-24. Less expensive alternative medications. -- (a) For pharmaceutical purchases

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eligible for reimbursement under the Medicaid state plan, the department shall encourage the

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substitution of generic drugs which are therapeutically equivalent and interchangeable with

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specific brand name drugs in accordance with section 21-31-16.1 and related regulations of the

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department of health, except in the event that a brand name is determined by the director to be

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less costly to the state than the equivalent generic. Calculation of comparative drug costs shall

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include consideration of the amount paid by the state to the pharmacy for a drug under the current

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retail pharmacy reimbursement formula, less any discounts or rebates, including those paid

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pursuant to federal Medicaid law during the previous calendar quarter, and inclusive of all

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dispensing fees.

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     (b) The department shall not require a beneficiary to use, prior to using a brand name

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prescription drug prescribed by a licensed prescriber, any alternative brand name prescription

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drug or over-the-counter drugs.

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     (c) The department may require a beneficiary to use, prior to using a brand name

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prescription drug prescribed by a licensed prescriber, a therapeutically equivalent generic drug,

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unless, pursuant to sections 5-19.1-19, 5-37-18.1 and 21-31-15(b), the prescriber indicates “brand

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name necessary” on the prescription form, or if the prescriber gives oral directions to that effect

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to the dispensing pharmacist.

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     SECTION 2. This act shall take effect on July 1, 2012.

     

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LC01727

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO HUMAN SERVICES - MEDICAL ASSISTANCE

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     This act would prevent the department of human services from requiring a Medicaid

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beneficiary to use an alternative brand name prescription drug or over-the-counter drug prior to

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using a brand name prescription drug prescribed by a licensed physician.

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     This act would take effect on July 1, 2012.

     

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LC01727

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H7650