Bill Text: IA SSB1134 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to prescription drugs, including the drug prescribing and dispensing information program, medication-assisted treatment insurance and Medicaid coverage, partial dispensing for opioid medication, and allocation of moneys to the pharmaceutical collection and disposal program.
Spectrum: Committee Bill
Status: (N/A - Dead) 2017-02-28 - Subcommittee recommends indefinite postponement. [SSB1134 Detail]
Download: Iowa-2017-SSB1134-Introduced.html
Senate
Study
Bill
1134
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
SEGEBART)
A
BILL
FOR
An
Act
relating
to
prescription
drugs,
including
the
1
drug
prescribing
and
dispensing
information
program,
2
medication-assisted
treatment
insurance
and
Medicaid
3
coverage,
partial
dispensing
for
opioid
medication,
and
4
allocation
of
moneys
to
the
pharmaceutical
collection
and
5
disposal
program.
6
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
7
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Section
1.
Section
124.551,
Code
2017,
is
amended
by
adding
1
the
following
new
subsection:
2
NEW
SUBSECTION
.
3A.
Each
board
created
under
chapter
3
147
that
licenses
a
prescribing
practitioner
shall
develop
a
4
process
to
integrate
automatic
registration
for
the
program
as
5
part
of
the
board’s
licensure
application
and
renewal
process.
6
Nothing
in
this
subsection
shall
require
a
prescribing
7
practitioner
to
obtain
information
about
a
patient
from
the
8
program.
9
Sec.
2.
Section
124.553,
subsection
8,
Code
2017,
is
amended
10
to
read
as
follows:
11
8.
The
board
may
enter
into
an
agreement
with
a
prescription
12
database
or
monitoring
program
operated
in
a
any
state
13
bordering
this
state
or
in
the
state
of
Kansas
for
the
mutual
14
exchange
of
information.
Any
agreement
entered
into
pursuant
15
to
this
subsection
shall
specify
that
all
the
information
16
exchanged
pursuant
to
the
agreement
shall
be
used
and
17
disseminated
in
accordance
with
the
laws
of
this
state.
18
Sec.
3.
NEW
SECTION
.
155A.28A
Partial
dispensing
of
19
prescription
for
opioid
medication.
20
1.
a.
Notwithstanding
any
provision
of
law
to
the
21
contrary,
a
pharmacist
may
dispense
a
prescription
for
an
22
opioid
medication
in
a
lesser
quantity
than
the
recommended
23
full
quantity
indicated
on
the
prescription
if
requested
by
24
the
patient
for
whom
the
prescription
is
written
or
the
legal
25
guardian
of
the
patient
for
whom
the
prescription
is
written.
26
b.
If
a
pharmacist
partially
dispenses
a
prescription
in
27
accordance
with
this
section,
the
remaining
quantity
of
the
28
prescription
not
dispensed
shall
not
be
dispensed
without
a
new
29
prescription.
30
2.
If
a
pharmacist
partially
dispenses
a
prescription
for
31
an
opioid
medication
in
accordance
with
this
section,
the
32
pharmacist
or
an
authorized
agent
of
the
pharmacist
shall,
33
as
soon
as
is
practicable
but
not
more
than
seven
days
after
34
the
partial
dispensing,
notify
the
prescriber
of
the
quantity
35
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of
the
opioid
medication
actually
dispensed.
The
notice
may
1
be
conveyed
to
the
prescriber
by
a
notation
on
the
patient’s
2
electronic
health
record,
electronic
transmission,
facsimile,
3
or
telephone.
4
Sec.
4.
Section
155A.43,
Code
2017,
is
amended
to
read
as
5
follows:
6
155A.43
Pharmaceutical
collection
and
disposal
program
——
7
annual
allocation.
8
Of
the
fees
collected
pursuant
to
sections
124.301
and
9
147.80
and
this
chapter
155A
by
the
board
of
pharmacy,
and
10
retained
by
the
board
pursuant
to
section
147.82
,
not
more
than
11
one
hundred
seventy-five
thousand
dollars
may
be
allocated
12
the
board
may
annually
by
the
board
allocate
an
adequate
sum
13
for
administering
the
pharmaceutical
collection
and
disposal
14
program
originally
established
pursuant
to
2009
Iowa
Acts,
15
ch.
175,
§9
.
The
program
shall
provide
for
the
management
16
and
disposal
of
unused,
excess,
and
expired
pharmaceuticals
17
including
the
management
and
disposal
of
controlled
substances
18
pursuant
to
state
and
federal
regulations
.
The
board
of
19
pharmacy
may
cooperate
contract
with
the
Iowa
pharmacy
20
association
and
may
consult
with
the
department
and
sanitary
21
landfill
operators
in
administering
or
with
one
or
more
vendors
22
for
the
provision
of
supplies
and
services
to
manage
and
23
maintain
the
program
and
to
safely
and
appropriately
dispose
of
24
pharmaceuticals
collected
through
the
program.
25
Sec.
5.
NEW
SECTION
.
514C.31
Medication-assisted
treatment
26
coverage.
27
1.
As
used
in
this
section:
28
a.
“Behavioral
therapy”
means
individual,
family,
or
group
29
therapy
designed
to
help
a
patient
engage
in
the
treatment
30
process,
modify
the
patient’s
attitudes
and
behaviors
related
31
to
substance
use,
and
increase
healthy
life
skills.
32
b.
“Financial
requirements”
means
deductibles,
copayments,
33
coinsurance,
or
out-of-pocket
maximums.
34
c.
“Health
care
professional”
means
the
same
as
defined
in
35
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section
135.154.
1
d.
“Medication-assisted
treatment”
means
the
use
of
2
medications,
commonly
in
combination
with
counseling
and
3
behavioral
therapies,
to
provide
a
comprehensive
approach
to
4
the
treatment
of
substance-related
disorders.
5
e.
“Pharmacologic
therapy”
means
a
prescribed
course
6
of
treatment
that
may
include
methadone,
buprenorphine,
7
naloxone,
naltrexone,
or
other
federal
food
and
drug
8
administration-approved
or
evidence-based
medications
for
the
9
treatment
of
substance-related
disorders.
10
f.
“Substance-related
disorder”
means
the
same
as
defined
11
in
section
125.2.
12
2.
Notwithstanding
the
uniformity
of
treatment
requirements
13
of
section
514C.6,
a
policy,
contract,
or
plan
providing
for
14
third-party
payment
or
prepayment
of
health
or
medical
expenses
15
shall
provide
coverage
benefits
for
medication-assisted
16
treatment.
Such
benefits
shall
provide
coverage
for
but
not
be
17
limited
to
pharmacologic
therapies
and
behavioral
therapies.
18
3.
Medication-assisted
treatment
coverage
benefits
provided
19
for
under
this
section
shall
not
be
subject
to
any
of
the
20
following:
21
a.
Any
annual
or
lifetime
dollar
limitations.
22
b.
Limitations
to
a
predesignated
facility,
specific
number
23
of
visits,
days
of
coverage,
days
in
a
waiting
period,
scope
or
24
duration
of
treatment,
or
other
similar
limits.
25
c.
Different
financial
requirements
than
for
other
illnesses
26
covered
under
the
policy,
contract,
or
plan.
27
d.
Step
therapy,
fail-first,
or
other
similar
drug
28
utilization
strategies
or
policies
for
covered
persons
that
may
29
conflict
with
a
prescribed
course
of
treatment
from
a
licensed
30
health
care
professional.
31
4.
Requirements
for
coverage
under
this
section
shall
not
32
be
subject
to
a
covered
person’s
prior
successes
or
failures
33
associated
with
the
services
provided.
34
5.
The
provisions
of
this
section
shall
apply
to
all
35
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third-party
payment
provider
contracts,
policies,
or
plans
1
delivered,
issued
for
delivery,
continued,
or
renewed
in
this
2
state
on
or
after
July
1,
2017.
3
6.
Any
contract
provision,
written
policy,
or
written
4
procedure
in
violation
of
this
section
shall
be
unenforceable
5
and
null
and
void.
6
Sec.
6.
MEDICAID
MEDICATION-ASSISTED
TREATMENT
MEDICATIONS
7
AND
SERVICES.
The
department
of
human
services
shall
adopt
8
rules
pursuant
to
chapter
17A
to
require
the
Iowa
Medicaid
9
program
to
cover
the
medication-assisted
treatment
medications
10
and
services
provided
for
under
section
514C.31,
as
enacted
11
in
this
Act,
and
include
those
medication-assisted
treatment
12
medications
in
its
preferred
drug
lists
for
the
treatment
of
13
substance-related
disorders
and
prevention
of
overdose
and
14
death.
The
list
of
medication-assisted
treatment
medications
15
provided
for
under
section
514C.31,
as
enacted
in
this
Act,
16
shall
not
be
deemed
to
be
exclusive,
and,
as
new
formulations
17
and
medications
are
approved
by
the
federal
food
and
drug
18
administration
for
use
in
the
treatment
of
substance-related
19
disorders,
the
Iowa
Medicaid
program
shall
update
its
preferred
20
drug
lists.
21
EXPLANATION
22
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
23
the
explanation’s
substance
by
the
members
of
the
general
assembly.
24
This
bill
makes
several
changes
to
the
drug
prescribing
25
and
dispensing
program
maintained
by
the
board
of
pharmacy
in
26
accordance
with
Code
chapter
124.
The
bill
requires
each
board
27
created
under
Code
chapter
147
that
licenses
a
prescribing
28
practitioner
to
develop
a
process
to
integrate
automatic
29
registration
for
the
program
as
part
of
that
board’s
licensure
30
application
and
renewal
process.
31
Currently,
the
board
of
pharmacy
may
enter
into
an
agreement
32
with
a
prescription
database
or
monitoring
program
operated
in
33
Kansas
or
a
state
bordering
Iowa.
The
bill
allows
the
board
34
to
enter
into
such
an
agreement
with
a
program
operated
in
any
35
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state.
1
The
bill
allows
a
pharmacist
to
dispense
a
prescription
for
2
an
opioid
medication
in
a
lesser
quantity
than
the
recommended
3
full
quantity
indicated
on
the
prescription
if
requested
by
the
4
patient
for
whom
the
prescription
is
written
or
the
patient’s
5
legal
guardian.
If
a
pharmacist
does
this,
the
remaining
6
quantity
of
the
prescription
shall
not
be
dispensed
without
a
7
new
prescription.
Also,
the
pharmacist
or
an
authorized
agent
8
of
the
pharmacist
shall,
as
soon
as
is
practicable
but
not
9
more
than
seven
days
after
the
partial
dispensing,
notify
the
10
prescriber
of
the
quantity
of
the
opioid
medication
actually
11
dispensed.
12
Currently,
the
board
of
pharmacy
may
annually
allocate
13
not
more
than
$175,000
for
administering
the
pharmaceutical
14
collection
and
disposal
program.
The
bill
allows
the
board
15
of
pharmacy
to
allocate
an
adequate
sum
for
the
program
every
16
year.
The
bill
also
allows
the
board
of
pharmacy
to
contract
17
with
one
or
more
vendors
for
the
provision
of
supplies
and
18
services
to
manage
and
maintain
the
program
and
to
safely
and
19
appropriately
dispose
of
pharmaceuticals
collected
through
the
20
program.
21
The
bill
establishes
requirements
for
insurance
coverage
22
for
“medication-assisted
treatment”,
defined
by
the
bill
23
as
the
use
of
medications,
commonly
in
combination
with
24
counseling
and
behavioral
therapies,
to
provide
a
comprehensive
25
approach
to
the
treatment
of
substance-related
disorders.
The
26
bill
specifies
that
all
policies,
contracts,
or
plans
for
27
third-party
payment
of
health
or
medical
benefits
must
provide
28
coverage
for
medication-assisted
treatment
including
but
not
29
limited
to
pharmacologic
and
behavioral
therapies.
The
bill
30
nullifies
any
contract
provision,
written
policy,
or
written
31
procedure
in
violation
of
the
bill.
32
The
bill
directs
the
department
of
human
services
to
33
adopt
rules
to
require
the
Iowa
Medicaid
program
to
cover
34
medication-assisted
treatment
medications
and
services
and
35
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