SENATE AMENDMENT
    Bill No. CS for CS for SB 792
    Amendment No. ___   Barcode 471714
                            CHAMBER ACTION
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11  Senator Silver moved the following amendment:
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13         Senate Amendment 
14         On page 58, lines 19-28, delete those lines
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16  and insert:  
17         (7)  The agency may establish a preferred drug
18  formulary in accordance with 42 U.S.C. s. 1396r-8, and,
19  pursuant to the establishment of such formulary, it is
20  authorized to negotiate supplemental rebates from
21  manufacturers that are in addition to those required by Title
22  XIX of the Social Security Act and at no less than 10 percent
23  of the average manufacturer price as defined in 42 U.S.C. s.
24  1936 on the last day of a quarter unless the federal or
25  supplemental rebate, or both, equals or exceeds 25 percent.
26  There is no upper limit on the supplemental rebates the agency
27  may negotiate. The agency may determine that specific
28  products, brand-name or generic, are competitive at lower
29  rebate percentages. Agreement to pay the minimum supplemental
30  rebate percentage will guarantee a manufacturer that the
31  Medicaid Pharmaceutical and Therapeutics Committee will
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    8:27 PM   05/02/01                              s0792c2b-38rma


                                                  SENATE AMENDMENT
    Bill No. CS for CS for SB 792
    Amendment No. ___   Barcode 471714
 1  consider a product for inclusion on the preferred drug
 2  formulary. However, a pharmaceutical manufacturer is not
 3  guaranteed placement on the formulary by simply paying the
 4  minimum supplemental rebate. Agency decisions will be made on
 5  the clinical efficacy of a drug and recommendations of the
 6  Medicaid Pharmaceutical and Therapeutics Committee, as well as
 7  the price of competing products minus federal and state
 8  rebates. The agency is authorized to contract with an outside
 9  agency or contractor to conduct negotiations for supplemental
10  rebates. For the purposes of this section, the term
11  "supplemental rebates" may include, at the agency's
12  discretion, cash rebates and other program benefits that
13  offset a Medicaid expenditure. Such other program benefits may
14  include, but are not limited to, disease management programs,
15  drug product donation programs, drug utilization control
16  programs, prescriber and beneficiary counseling and education,
17  fraud and abuse initiatives, and other services or
18  administrative investments with guaranteed savings to the
19  Medicaid program in the same year the rebate reduction is
20  included in the General Appropriations Act. The agency is
21  authorized to seek any federal waivers to implement this
22  initiative.
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    8:27 PM   05/02/01                              s0792c2b-38rma