Effective - 28 Aug 2012
338.320. Committee established, purpose, members, duties — sunset provision. — 1. There is hereby established the "Missouri Electronic Prior Authorization Committee" in order to facilitate, monitor, and report to the general assembly on Missouri-based efforts to contribute to the establishment of national electronic prior authorization standards. Such efforts shall include the Missouri-based electronic prior authorization pilot program established under subsection 5 of this section and the study and dissemination of information by the committee of the efforts of the National Council on Prescription Drug Programs (NCPDP) to develop national electronic prior authorization standards. The committee shall advise the general assembly and the department of commerce and insurance as to whether there is a need for administrative rules to be promulgated by the department of commerce and insurance as soon as practically possible.
2. The Missouri electronic prior authorization committee shall consist of the following members:
(1) Two members of the senate, appointed by the president pro tempore of the senate;
(2) Two members of the house of representatives, appointed by the speaker of the house of representatives;
(3) One member from an organization of licensed physicians in the state;
(4) One member who is a physician licensed in Missouri pursuant to chapter 334;
(5) One member who is a representative of a Missouri pharmacy benefit management company;
(6) One member from an organization representing licensed pharmacists in the state;
(7) One member from the business community representing businesses on health insurance issues;
(8) One member from an organization representing the leading research-based pharmaceutical and biotechnology companies;
(9) One member from an organization representing the largest generic pharmaceutical trade association;
(10) One patient advocate;
(11) One member from an electronic prescription network that facilitates the secure electronic exchange of clinical information between physicians, pharmacies, payers, and pharmacy benefit managers and other health care providers;
(12) One member from a Missouri-based electronic health records company;
(13) One member from an organization representing the largest number of hospitals in the state;
(14) One member from a health carrier as such term is defined under section 376.1350;
(15) One member from an organization representing the largest number of health carriers in the state, as such term is defined under section 376.1350;
(16) The director of the department of social services, or the director's designee;
(17) The director of the department of commerce and insurance, who shall be chair of the committee.
3. All of the members, except for the members from the general assembly, shall be appointed by the governor no later than September 1, 2012, with the advice and consent of the senate. The staff of the department of commerce and insurance shall provide assistance to the committee.
4. The duties of the committee shall be as follows:
(1) Before February 1, 2019, monitor and report to the general assembly on the Missouri-based electronic prior authorization pilot program created under subsection 5 of this section including a report of the outcomes and best practices developed as a result of the pilot program and how such information can be used to inform the national standard-setting process;
(2) Obtain specific updates from the NCPDP and other pharmacy benefit managers and vendors that are currently engaged in pilot programs working toward national electronic prior authorization standards;
(3) Correspond and collaborate with the NCPDP and other such pilots through the exchange of information and ideas;
(4) Assist, when asked by the pharmacy benefit manager, with the development of the pilot program created under subsection 5 of this section with an understanding of information on the success and failures of other pilot programs across the country;
(5) Prepare a report at the end of each calendar year to be distributed to the general assembly and governor with a summary of the committee's progress and plans for the next calendar year, including a report on Missouri-based efforts to contribute to the establishment of national electronic prior authorization standards. Such annual report shall continue until such time as the NCPDP has established national electronic prior authorization standards or this section has expired, whichever is sooner. The first report shall be completed before January 1, 2013;
(6) Upon the adoption of national electronic prior authorization standards by the NCPDP, prepare a final report to be distributed to the general assembly and governor that identifies the appropriate Missouri administrative regulations, if any, that will need to be promulgated by the department of commerce and insurance, in order to make those standards effective as soon as practically possible, and advise the general assembly and governor if there are any legislative actions necessary to the furtherance of that end.
5. The department of commerce and insurance and the Missouri electronic prior authorization committee shall recruit a Missouri-based pharmacy benefits manager doing business nationally to volunteer to conduct an electronic prior authorization pilot program in Missouri. The pharmacy benefits manager conducting the pilot program shall ensure that there are adequate Missouri licensed physicians and an electronic prior authorization vendor capable and willing to participate in a Missouri-based pilot program. Such pilot program established under this section shall be operational by January 1, 2014. The department and the committee may provide advice or assistance to the pharmacy benefit manager conducting the pilot program but shall not maintain control or lead with the direction of the pilot program.
6. Pursuant to section 23.253 of the Missouri sunset act:
(1) The provisions of the new program authorized under this section shall sunset automatically six years after August 28, 2012, unless reauthorized by an act of the general assembly; and
(2) If such program is reauthorized, the program authorized under this section shall sunset automatically twelve years after the effective date of the reauthorization of this section; and
(3) This section shall terminate on September first of the calendar year immediately following the calendar year in which the program authorized under this section is sunset.
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(L. 2012 H.B. 1563 merged with H.B. 1827)
Sunset date 8-28-18
Termination date 9-01-19
Structure Missouri Revised Statutes
Title XXII - Occupations and Professions
Chapter 338 - Pharmacists and Pharmacies
Section 338.030 - Applicant — requirements for qualification.
Section 338.043 - Temporary license — eligibility — renewal.
Section 338.050 - Pharmacist license, issued when, period covered.
Section 338.056 - Generic substitutions, when, requirements — violations, penalty.
Section 338.059 - Prescriptions, how labeled.
Section 338.065 - Disciplinary hearings — grounds for discipline.
Section 338.067 - Revocation and restoration of license — conditions.
Section 338.080 - Display of license or renewal required.
Section 338.090 - Sale of poisons — regulations.
Section 338.100 - Records required to be kept — requirements.
Section 338.110 - Board of pharmacy, members, qualifications, terms.
Section 338.120 - Board of pharmacy — organization.
Section 338.130 - Compensation of board members, personnel.
Section 338.132 - Board of pharmacy, salary schedule for employees to be established.
Section 338.142 - Drug take-back program, board authorized to expend, allocate, or award funds.
Section 338.155 - Immunity from civil liability, when.
Section 338.170 - Title of pharmacist — used by whom.
Section 338.180 - Prosecution of offenders.
Section 338.185 - Board has access to certain court records.
Section 338.190 - Violation of law by licensee — penalty.
Section 338.195 - Violation of law by person not licensed — penalty.
Section 338.198 - Pharmacist may fill prescription forwarded by authorized agent.
Section 338.205 - Opioid antagonist, storage and dispensing of without a license, when.
Section 338.230 - Disposition of fees.
Section 338.270 - Renewal applications to be made, when.
Section 338.280 - Board of pharmacy, rules and regulations.
Section 338.285 - Board may file complaint, when, where filed.
Section 338.290 - Appeals from decision of board, notice of right.
Section 338.300 - Permit to be posted — not transferable.
Section 338.310 - Violation, a misdemeanor.
Section 338.320 - Committee established, purpose, members, duties — sunset provision.
Section 338.330 - Definitions.
Section 338.335 - Separate licenses required, when — exemptions.
Section 338.337 - Out-of-state distributors, licenses required, exception.
Section 338.340 - Sale of drugs, out-of-state distributor, license required.
Section 338.343 - Records to be maintained and be available for board inspection.
Section 338.347 - Renewal of license, application.
Section 338.350 - Board of pharmacy to promulgate rules and regulations — procedure.
Section 338.357 - Sanction imposed by board, when.
Section 338.360 - Inspection of premises allowed, when.
Section 338.365 - Injunction may be issued, when, procedure.
Section 338.400 - Standard of care, definitions, rules.
Section 338.500 - Gross retail prescriptions, tax imposed, definitions.
Section 338.505 - Formula for tax liability, rulemaking authority, appeals procedure.
Section 338.515 - Effective date of tax.
Section 338.530 - Offset against Medicaid payments due by pharmacy permitted, when.
Section 338.535 - Remittance to department — pharmacy reimbursement allowance fund created.
Section 338.550 - Expiration date of tax, when.
Section 338.650 - Fund established, use of moneys.
Section 338.700 - Definitions.
Section 338.710 - Program created, goal — authority of board — evaluation report — expiration date.