SB1807 Amendment Summary

• Requires pharmacy reimbursement requests to include prescriber name or Department-established identification number for prescription drug reimbursement under Medicaid.

• Establishes pharmacy reimbursement rate including professional dispensing fee plus current acquisition cost, with Department updating drug acquisition cost information at least every 30 days.

• Limits prescription drug reimbursement to 4 prescriptions (including maximum 3 brand name drugs) per 30-day period, unless prior approval granted; exempts immunosuppressant, oncolytic, and anti-retroviral drugs from this limit.

• Adds exemption from 4-prescription limit for antipsychotic and anticonvulsant drugs used to treat post-traumatic stress disorder, schizophrenia, schizoaffective disorder, bipolar disorder, panic disorder, and epilepsy.

• Requires providers eligible for federal Drug Pricing Program (Section 340B) to enroll in that program when billing Department for outpatient drugs.