2023 Louisiana Laws › Revised Statutes › Title 46 - Public Welfare and Assistance › §46:460.37. Council on Medicaid Pharmacy Reimbursement; creation; composition, purpose, and duties of the council

RS 46:460.37 - Council on Medicaid Pharmacy Reimbursement; creation; composition, purpose, and duties of the council
A. There is hereby created within the Louisiana Department of Health the Council on Medicaid Pharmacy Reimbursement, referred to in this Section as the "council".
B. The council shall be composed of the following members:
(1) The Medicaid director of the Louisiana Department of Health or his designee.
(2) The president of the Louisiana Pharmacists Association or his designee.
(3) The president of the Louisiana Independent Pharmacies Association or his designee.
(4) A representative of the Louisiana Alliance of Retail Pharmacies appointed by the executive director of the Louisiana Retailers Association.
(5) The president of the National Association of Chain Drug Stores or his designee.
(6) One pharmacist appointed by the chairman of the Senate Committee on Health and Welfare.
(7) One physician appointed by the chairman of the Senate Committee on Health and Welfare.
(8) One pharmacist appointed by the chairman of the House Committee on Health and Welfare.
(9) One physician appointed by the chairman of the House Committee on Health and Welfare.
(10) Two licensed pharmacists appointed by the Louisiana Board of Pharmacy who are not currently serving on the board. The board shall strive to ensure its appointments demonstrate race, gender, ethnic, and geographical diversity.
C.(1)(a) Members of the council provided for in Paragraphs (B)(1) through (5) of this Section shall serve a term concurrent with their tenure in the qualifying office. Appointed members of the council provided for in Paragraphs (B)(6) through (10) of this Section shall serve at the pleasure of the appointing authority. Designees of members shall serve at the pleasure of the designating member not to exceed the term of the designating member.
(b) Appointed members of the council provided for in Paragraphs (B)(6) through (10) of this Section shall be licensed and in good standing with their respective licensing board, actively engaged in their profession, and participating in the Medicaid program.
(2) Six members shall constitute a quorum for the transaction of all business. The members shall elect a chairperson and vice chair whose duties shall be established by the council. The member elected to serve as chairperson shall fix a time and place for regular meetings of the council, which shall meet at least quarterly. The council shall establish policies and procedures necessary to carry out its duties.
(3) Members of the council shall serve without compensation.
(4) The secretary shall designate the appropriate staff to provide support to the council and supply data regarding Medicaid pharmacy claims to inform the work of the council. All information provided to the council shall be either redacted or reported in the aggregate to protect the confidentiality of the information or to protect a person's reasonable right to privacy.
D.(1) The council shall perform all of the following tasks:
(a) Review Medicaid pharmacy reimbursement data and trends and establish a process by which pharmacists can provide information showing that current reimbursement does not cover the reasonable and appropriate cost for a specific pharmaceutical.
(b) Provide a platform for pharmacists to submit ideas and express concerns and a venue for public testimony on Medicaid reimbursements.
(c) Make recommendations to the secretary regarding needed changes to Medicaid pharmacy reimbursement policies and procedures, including but not limited to enhanced reimbursements for specific pharmaceuticals upon a showing that the current reimbursement does not cover the reasonable and appropriate costs and inhibits patient access to prescribed, medically necessary pharmaceuticals.
(d) Advise the secretary on alleged violations committed by Medicaid managed care organizations, pharmacy benefit managers, or any other entity that provides any service related to prescription drug administration or benefits.
(e) Make annual recommendations to the secretary regarding the implementation and administration of a Medicaid medication therapy management program pursuant to R.S. 46:153.3.1.
(f) Any other task related to the Medicaid pharmacy program, including but not limited to Medicaid prescription drug administration, drug rebates, and reimbursement.
(2) In carrying out the duties provided for in Paragraph (1) of this Subsection, the council may consult with health benefit plan issuers, Medicaid managed care organizations, pharmacy benefit managers, wholesale drug distributors, and other interested stakeholders.
Acts 2022, No. 292, §1.