Senate Bill sb2306

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    Florida Senate - 2005                                  SB 2306

    By Senator Geller





    31-1589-05

  1                      A bill to be entitled

  2         An act relating to a prescription drug

  3         reimportation program; providing legislative

  4         findings; providing definitions; authorizing

  5         the Agency for Health Care Administration to

  6         enter into an agreement with the state of

  7         Illinois regarding its program for accessing

  8         affordable prescription drugs in other

  9         countries; requiring the agency to maintain a

10         web site; requiring the agency to work with

11         other states that are participating in the

12         program; creating a joint work group for

13         administration of the program; authorizing the

14         state of Illinois to act as primary

15         administrator for the program; providing for

16         standards of practice; providing for

17         modification of the agreement; providing for

18         the state of Illinois to provide notice to the

19         agency regarding the addition of another state

20         to the program; authorizing the state of

21         Illinois and the agency to conduct inspections

22         of network pharmacies; providing that only

23         prescription drugs that are approved by the

24         state of Illinois may be filled by the network

25         pharmacies; providing for the agency and the

26         state of Illinois to coordinate media and

27         outreach efforts; requiring the pharmacy

28         benefits manager to pay acquisition fees to the

29         program for certain purposes; providing that

30         the agency is entitled to a certain amount of

31         the acquisition fees; authorizing the state of

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    Florida Senate - 2005                                  SB 2306
    31-1589-05




 1         Illinois or the agency to withdraw from the

 2         agreement; providing that the state of Illinois

 3         or the agency is not liable for acts or

 4         omission of acts arising from the agreement;

 5         creating a working group to develop promotional

 6         tools related to the program; providing duties

 7         of the working group; providing that the agency

 8         is not liable for any injury or damage to a

 9         person from products obtained through the

10         program; providing an effective date.

11  

12  Be It Enacted by the Legislature of the State of Florida:

13  

14         Section 1.  Prescription drug reimportation program.--

15         (1)  LEGISLATIVE FINDINGS.--The Legislature makes the

16  following findings of fact:

17         (a)  I-SaveRx is a prescription drug program

18  implemented by the state of Illinois in October 2004.

19         (b)  I-SaveRx allows Illinois residents to refill

20  prescriptions for the most-common brand-name prescription

21  drugs used to treat chronic illnesses from a network of

22  inspected and approved pharmacies in Canada and the United

23  Kingdom. The mail-order pharmacy program is accessible through

24  a web site and a 24-hour, toll-free telephone number.

25         (c)  Participants in I-SaveRx are expected to save from

26  25 to 50 percent on the cost of medications. The program

27  includes provisions to ensure the safety and quality of the

28  prescriptions by requiring the inspection and approval of the

29  pharmacies who participate.

30         (d)  Since implementation of I-SaveRx, Wisconsin,

31  Missouri, Kansas, and Vermont have joined the program.

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    Florida Senate - 2005                                  SB 2306
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 1         (e)  Residents of this state require timely access to

 2  safe, high-quality, and efficacious prescription drugs that

 3  are not available in the United States at affordable prices.

 4         (f)  The state of Illinois has expended significant

 5  time and resources in inspecting and ensuring the safety of

 6  pharmacies in Canada and Europe. It has contracted with a

 7  pharmacy benefit manager for services, including the provision

 8  of certain prescription drugs from Canada, Ireland, and the

 9  United Kingdom, in a safe and affordable manner.

10         (g)  Reimportation is not a comprehensive, long-term

11  solution to the problem of drug affordability; however,

12  I-SaveRx will provide residents of this state with an interim

13  option for obtaining safe and affordable prescription drugs.

14         (2)  DEFINITIONS.--As used in this section, the term:

15         (a)  "Agency" means the Agency for Health Care

16  Administration.

17         (b)  "Network pharmacy" means a pharmacy that is

18  participating in the network set up by the pharmacy benefit

19  manager. The term "network pharmacies" has the same meaning as

20  it has under the PBM agreement.

21         (c)  "Pharmacy benefits management" or "PBM" means the

22  procurement of prescription drugs at a negotiated rate for

23  dispensation within the state to covered individuals, the

24  administration or management of prescription drug benefits

25  provided by a covered entity for the benefit of covered

26  individuals, or any of the following services provided with

27  regard to the administration of pharmacy benefits:

28         1.  Mail service-pharmacy;

29         2.  Claims processing, retail network management, and

30  payment of claims to pharmacies for prescription drugs

31  dispensed to covered individuals;

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    Florida Senate - 2005                                  SB 2306
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 1         3.  Clinical formulary development and management

 2  services;

 3         4.  Rebate contracting and administration;

 4         5.  Patient compliance, therapeutic intervention, and

 5  generic-substitution programs; and

 6         6.  Disease management programs.

 7         (d)  "Pharmacy benefit manager" means an entity that

 8  performs pharmacy benefits management. The term includes a

 9  person or entity acting for a pharmacy benefits manager in a

10  contractual or employment relationship in the performance of

11  pharmacy benefits management for a covered entity and includes

12  mail-service pharmacy.

13         (3)(a)  The agency may enter into an agreement with the

14  state of Illinois regarding access for each state's residents

15  to safe and affordable prescription drugs from Canada,

16  Ireland, and the United Kingdom through the state of Illinois

17  I-SaveRx program.

18         (b)1.  The agency shall maintain a separate web site

19  that provides a link to www.I-SaveRx.net. In its pharmacy

20  benefits management agreement with its pharmacy benefits

21  manager, the state of Illinois must specify that Florida

22  residents with zip code addresses in this state shall be

23  provided access to the services available through the I-SaveRx

24  program and that residents of this state shall be considered

25  "program participants," as that term is defined in the PBM

26  agreement. The operation and administration of the web site

27  accessed via the I-SaveRx site will be the responsibility of

28  the pharmacy benefits manager, as is outlined in the PBM

29  agreement.

30         2.  The agency shall work with other participating

31  states to ensure an adequate supply of prescription drugs from

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    Florida Senate - 2005                                  SB 2306
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 1  the program countries. If demand exceeds the supplies

 2  available, the state of Illinois must be given first priority

 3  over all other program participants. The term "participating

 4  states" means Illinois and any other state that enters or has

 5  entered into an agreement with the state of Illinois to

 6  participate in the I-SaveRx program.

 7         (c)1.  To ensure adequate input regarding the safe and

 8  effective administration of the I-SaveRx program, the agency

 9  shall be part of the Joint Work Group (JWG), composed of two

10  representatives from each participating state. The JWG shall

11  meet or confer on an as-needed basis. The representatives from

12  this state shall be the Secretary of Health Care

13  Administration or his or her designee and the chair of the

14  Board of Pharmacy or his or her designee.

15         2.  The state of Illinois shall act as the primary

16  administrator of the PBM agreement. To ensure the safety of

17  their respective residents, the participating states have

18  agreed upon a single set of standards of practice, outlined in

19  schedule A of the PBM agreement. These standards of practice

20  are incorporated into the PBM agreement between Illinois and

21  the pharmacy benefits manager. Under the PBM agreement, the

22  pharmacy benefits manager and the network pharmacies shall

23  comply with the agreed-upon standards of practice.

24         3.  Any reports issued by the pharmacy benefits manager

25  or local regulatory authorities regarding the network

26  pharmacies' compliance, or lack thereof, with the standards of

27  practice shall be provided to this state. The JWG shall

28  determine the specific types of data that should be included

29  in any such reports issued by the pharmacy benefits manager

30  and the periodic basis on which such reports are issued.

31  

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    Florida Senate - 2005                                  SB 2306
    31-1589-05




 1         4.  If the state of Illinois or the pharmacy benefits

 2  manager wishes to modify the agreed-upon standards of

 3  practice, the state of Illinois will notify the agency in

 4  writing at least 15 days before the planned implementation of

 5  such amendment or modification. The standards of practice may

 6  not, under any circumstances, be modified or amended without

 7  the full and unanimous consent of the JWG.  Additionally, the

 8  JWG shall review the standards of practice periodically for

 9  the purpose of considering modifications or amendments.

10         5.  If the standards of practice are violated by any

11  network pharmacy, the agency shall provide written notice to

12  the state of Illinois and the pharmacy benefits manager of

13  such violation. Upon receiving such written notice from the

14  agency, the state of Illinois shall instruct the pharmacy

15  benefits manager to suspend such pharmacy immediately from the

16  list of network pharmacies eligible to fill prescriptions for

17  program participants, pending a further review by the pharmacy

18  benefits manager and the participating states which may result

19  in either reinstatement or exclusion from participation in the

20  program.

21         6.  If other states, in addition to this state, join

22  the state of Illinois in providing access to prescription

23  drugs through the I-SaveRx program, the state of Illinois

24  shall provide written notice to the agency. Further, the state

25  of Illinois should ensure that such addition of other states

26  will not in any way render less stringent the existing

27  standards of practice.

28         7.  Under the PBM agreement, the state of Illinois may

29  conduct on-site inspections of the network pharmacies with or

30  without advance notice. The agency also may participate in

31  such inspections along with the state of Illinois. To the

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    Florida Senate - 2005                                  SB 2306
    31-1589-05




 1  extent that additional pharmacies are added to the list of

 2  network pharmacies, the agency may also inspect those

 3  pharmacies independently. The agency shall provide in writing

 4  to the state of Illinois any plans or intentions of the agency

 5  to inspect independently 14 days before such inspection,

 6  unless the inspection is an investigation of a complaint.

 7         8.  Under the PBM agreement, only those prescription

 8  drugs approved by the state of Illinois shall be filled by the

 9  network pharmacies for the I-SaveRx program participants. The

10  JWG shall review the approved drug list periodically and

11  consider any proposed changes. The approved drug list may not

12  be modified without the consent of the JWG. Only if the JWG

13  cannot agree on a proposed modification to the drug list shall

14  the voting power of the JWG be determined by the respective

15  populations of the participating states.

16         (d)  The state of Illinois and the agency shall

17  coordinate, where mutually beneficial, media and outreach

18  efforts. Additionally, with input from the state of Illinois,

19  the agency shall independently promote the I-SaveRx program.

20  The agency shall use the name, logo, web site, and marketing

21  materials that have been developed by the state of Illinois;

22  however, the state seal and the Governor's name may be added

23  to the materials. The pharmacy benefits manager shall pay

24  I-SaveRx acquisition fees to the program to be used for such

25  activities as marketing, outreach, and additional inspections.

26  The agency is entitled to such pool of acquisition fees in an

27  amount proportional to the percentage of I-SaveRx prescription

28  drug sales attributable to zip codes in this state.

29         (e)  The state of Illinois or the agency may withdraw

30  from this agreement and terminate this cooperative

31  relationship at any time, without cause, upon written notice

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    Florida Senate - 2005                                  SB 2306
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 1  to the other states.  Withdrawal by the agency may be

 2  accomplished by act of the Legislature.

 3         (f)  The agency, its employees, agents, or

 4  representatives taking any act as a result of this agreement

 5  are not liable for any acts or omissions of the state of

 6  Illinois or its agencies, employees, agents, or

 7  representatives in carrying out the activities governed by

 8  this agreement. The state of Illinois, its agencies,

 9  employees, agents, or representatives taking any act as a

10  result of this agreement are not liable for the acts or

11  omissions of the agency, its employees, agents, or

12  representatives in carrying out the activities governed by

13  this agreement.

14         (4)(a)  The Secretary of Health Care Administration or

15  his or her designee is responsible for implementing this act.

16         (b)  Within 21 days after the effective date of this

17  act, the Secretary of Health or his or her designee shall

18  convene a working group to develop outreach and promotion

19  tools related to the I-SaveRx program. The following six state

20  officials shall be members of the working group:

21         1.  The Secretary of Health Care Administration, or his

22  or her designee;

23         2.  The Secretary of Management Services, or his or her

24  designee;

25         3.  The Secretary of Elderly Affairs, or his or her

26  designee;

27         4.  The Secretary of Health, or his or her designee;

28         5.  The executive director of the Office of Insurance

29  Regulation, or his or her designee; and

30  

31  

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    Florida Senate - 2005                                  SB 2306
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 1         6.  The deputy secretary of the Division of Health

 2  Quality Assurance within the Agency for Health Care

 3  Administration, or his or her designee.

 4         (c)  Duties of the working group shall include

 5  developing communication tools, such as enrollment forms,

 6  explanatory brochures, a web site, inserts in utility and tax

 7  bills, and promotional magnets and posters, and directing

 8  outreach and material distribution to all health care

 9  providers and relevant health care associations.

10         (5)  The agency is not liable for any injury or damage

11  caused to a person from products obtained through the I-SaveRx

12  program.

13         Section 2.  This act shall take effect upon becoming a

14  law.

15  

16            *****************************************

17                          SENATE SUMMARY

18    Authorizes the Agency for Health Care Administration to
      enter into an agreement with the state of Illinois
19    regarding its program for accessing affordable
      prescription drugs in other countries. Requires the
20    agency to work with other states that are participating
      in the program. Creates a joint work group for
21    administration of the program. Authorizes the state of
      Illinois to act as primary administrator for the program.
22    Provides for modification of the agreement. The state of
      Illinois is to provide notice to the agency regarding the
23    addition of another state to the program. Authorizes the
      state of Illinois and the agency to conduct inspections
24    of network pharmacies. Provides that only prescription
      drugs that are approved by the state of Illinois may be
25    filled by the network pharmacies. Provides for the agency
      and the state of Illinois to coordinate media and
26    outreach efforts. Requires the pharmacy benefits manager
      to pay acquisition fees to the program for certain
27    purposes. Provides that the agency is entitled to a
      certain amount of the acquisition fees. Authorizes the
28    state of Illinois or the agency to withdraw from the
      agreement. Provides that the state of Illinois or the
29    agency is not liable for acts or omission of acts arising
      from the agreement. Creates a working group to develop
30    promotional tools related to the program. Provides that
      the agency is not liable for any injury or damage to a
31    person from products obtained through the program.

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