74th OREGON LEGISLATIVE ASSEMBLY--2007 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 1689
Senate Bill 362
Sponsored by Senator MORRISETTE (Presession filed.)
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 as
introduced.
Expands list of individuals and entities that may participate
in Oregon Prescription Drug Program. Requires Joint Legislative
Audit Committee to evaluate and report on effectiveness of
program.
A BILL FOR AN ACT
Relating to Oregon Prescription Drug Program; creating new
provisions; and amending ORS 414.312.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 414.312, as amended by section 1, chapter 2,
Oregon Laws 2007 (Ballot Measure 44 (2006)), is amended to read:
414.312. (1) As used in ORS 414.312 to 414.318:
(a) 'Pharmacy benefit manager' means an entity that, in
addition to being a prescription drug claims processor,
negotiates and executes contracts with pharmacies, manages
preferred drug lists, negotiates rebates with prescription drug
manufacturers and serves as an intermediary between the Oregon
Prescription Drug Program, prescription drug manufacturers and
pharmacies.
(b) 'Prescription drug claims processor' means an entity that
processes and pays prescription drug claims, adjudicates pharmacy
claims, transmits prescription drug prices and claims data
between pharmacies and the Oregon Prescription Drug Program and
processes related payments to pharmacies.
(c) 'Program price' means the reimbursement rates and
prescription drug prices established by the administrator of the
Oregon Prescription Drug Program.
(2) The Oregon Prescription Drug Program is established in the
Oregon Department of Administrative Services. The purpose of the
program is to:
(a) Purchase prescription drugs or reimburse pharmacies for
prescription drugs in order to receive discounted prices and
rebates;
(b) Make prescription drugs available at the lowest possible
cost to participants in the program; and
(c) Maintain a list of prescription drugs recommended as the
most effective prescription drugs available at the best possible
prices.
(3) The Director of the Oregon Department of Administrative
Services shall appoint an administrator of the Oregon
Prescription Drug Program. The administrator shall:
(a) Negotiate price discounts and rebates on prescription drugs
with prescription drug manufacturers;
(b) Purchase prescription drugs on behalf of individuals and
entities that participate in the program;
(c) Contract with a prescription drug claims processor to
adjudicate pharmacy claims and transmit program prices to
pharmacies;
(d) Determine program prices and reimburse pharmacies for
prescription drugs;
(e) Adopt and implement a preferred drug list for the program;
(f) Develop a system for allocating and distributing the
operational costs of the program and any rebates obtained to
participants of the program; and
(g) Cooperate with other states or regional consortia in the
bulk purchase of prescription drugs.
(4) The following individuals or entities may participate in
the program:
(a) Public Employees' Benefit Board;
(b) Local governments as defined in ORS 174.116 and special
government bodies as defined in ORS 174.117 that directly or
indirectly purchase prescription drugs;
(c) Enrollees in the Senior Prescription Drug Assistance
Program created under ORS 414.342;
(d) Oregon Health and Science University established under ORS
353.020;
(e) State agencies that directly or indirectly purchase
prescription drugs, including agencies that dispense prescription
drugs directly to persons in state-operated facilities;
{ - and - }
(f) Residents of this state who { + + } { - do not have - }
{ + lack or are underinsured for + } prescription drug
coverage { + ; + } { - . - }
{ + (g) Private entities; and
(h) Labor organizations. + }
(5) The state agency that receives federal Medicaid funds and
is responsible for implementing the state's medical assistance
program may not participate in the program.
(6) The administrator may establish different reimbursement
rates or prescription drug prices for pharmacies in rural areas
to maintain statewide access to the program.
(7) The administrator shall establish the terms and conditions
for a pharmacy to enroll in the program. A licensed pharmacy that
is willing to accept the terms and conditions established by the
administrator may apply to enroll in the program.
(8) Except as provided in subsection (9) of this section, the
administrator may not:
(a) Contract with a pharmacy benefit manager;
(b) Establish a state-managed wholesale or retail drug
distribution or dispensing system; or
(c) Require pharmacies to maintain or allocate separate
inventories for prescription drugs dispensed through the program.
(9) The administrator shall contract with one or more entities
to provide the functions of a prescription drug claims processor.
The administrator may also contract with a pharmacy benefit
manager to negotiate with prescription drug manufacturers on
behalf of the administrator.
(10) Notwithstanding subsection (4)(f) of this section,
individuals who are eligible for Medicare Part D prescription
drug coverage may participate in the program.
SECTION 2. { + Section 3 of this 2007 Act is added to and made
a part of ORS 414.312 to 414.318. + }
SECTION 3. { + By January 1, 2009, the Joint Legislative Audit
Committee shall conduct a performance audit on the operation of
the Oregon Prescription Drug Program under ORS 414.312. The audit
shall review the operations and outcomes associated with the
implementation of the program and identify net savings, if any,
to the participants in the program, the percentage of targeted
populations participating, and changes in health outcomes of
participants. + }
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