71st OREGON LEGISLATIVE ASSEMBLY--2001 Regular Session
 
NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .
 
LC 2849
 
                           A-Engrossed
 
                         House Bill 3311
                   Ordered by the House May 7
             Including House Amendments dated May 7
 
Sponsored by Representative C WALKER; Representatives BACKLUND,
  BATES, BROWN, CARLSON, GARRARD, JENSON, KNOPP, KRUMMEL, KRUSE,
  LEE, MINNIS, MONNES ANDERSON, SIMMONS, G SMITH, P SMITH, T
  SMITH, V WALKER, ZAUNER
 
 
                             SUMMARY
 
The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure.
 
  Requires enrollees of Oregon Health Plan to designate primary
pharmacy { +  or pharmacy network + }.
   { +  Requires Department of Human Services to adopt certain
rules.  Prohibits department from designating pharmacy or
pharmacy network as exclusive provider for enrollees. + }
 
                        A BILL FOR AN ACT
Relating to designation of primary pharmacy by enrollees of
  Oregon Health Plan.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + (1) As used in this section:
  (a) 'Pharmacy network' means a group of pharmacies using a
shared database or employing other electronic means to access
prescription information of enrollees from multiple points of
service.
  (b) 'Practitioner' has the meaning given that term in ORS
689.005.
  (2) At the time of enrollment in the Oregon Health Plan, an
enrollee shall designate a primary pharmacy or pharmacy network
to dispense prescription drugs prescribed by a practitioner and
covered by the medical assistance program under ORS chapter 414.
  (3) The Department of Human Services may not pay for
prescription drugs obtained by an enrollee at a pharmacy other
than the primary pharmacy or pharmacy network designated under
subsection (2) of this section unless:
  (a) The enrollee is more than 25 miles from the designated
primary pharmacy or pharmacy network and a practitioner indicates
to another pharmacy that the prescription drug is medically
necessary;
  (b) A practitioner indicates to another pharmacy that a
prescription drug is required for a medical emergency; or
  (c) Payment is authorized by administrative rules adopted by
the department.
 
 
  (4) The department shall adopt rules establishing procedures to
allow an enrollee to change a designation of a primary pharmacy
or pharmacy network.
  (5) The department may not establish or designate a pharmacy or
pharmacy network as exclusive providers of prescription or
pharmacy services for enrollees.
  (6) The department shall adopt rules that:
  (a) Establish procedures to ensure that a primary pharmacy or
pharmacy network will receive notice when an enrollee obtains a
prescription at another pharmacy; and
  (b) Allow payment at the point of sale to a pharmacy other than
a primary pharmacy or pharmacy network for a prescription
obtained by an enrollee as described in subsection (3)(a) or (b)
of this section. + }
  SECTION 2.  { + An enrollee of the Oregon Health Plan on or
before the effective date of this 2001 Act shall designate a
primary pharmacy or pharmacy network under section 1 of this 2001
Act at the beginning of the enrollee's next enrollment
period. + }
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