(a) The General Assembly finds that the department frequently must
pay more for prescription drugs furnished to recipients of medical
assistance under this article than certain health care providers pay
for the same products. In order to control more effectively the
costs of such drugs, the department may establish a Medicaid
Prescription Drug Bidding and Rebate Program as provided in this
Code section. (b) The department may request sealed bids from prescription drug
manufacturers for both brand name and generic equivalent
prescription drugs specified by the department. The bids shall be
proposed agreements by these manufacturers to adjust prices of drugs
specified by the department to a price designated as the bid price
when those drugs are supplied to recipients of medical assistance
under this article. If the department has accepted a bid for a drug
under this Code section, the department may not reimburse a provider
of such drug for any equivalent drug not so successfully bid during
the term of the contract awarded with regard to the drug so bid.
The department may elect not to reimburse for any multisource drugs
of a drug manufacturer which does not participate in the bid process
or which bids prices considered excessive by the department. (c) All prescription drugs for which bids are submitted must meet
applicable standards of the U.S. Pharmacopoeia, the State Board of
Pharmacy, and be guaranteed as meeting all requirements,
regulations, and comparison data under the Federal Food, Drug, and
Cosmetic Act and the regulations thereunder. The manufacturer of a
drug which is bid must have an FDA approved New Drug Application or
an abbreviated New Drug Application and must have a product
liability insurance policy extending to pharmacy providers under
this article, but the policy may condition coverage thereunder upon
the provider's complying with all applicable federal and state laws
and regulations promulgated thereunder. (d) Nothing in this Code section shall be construed to change the
practice of pharmacies having provider agreements under this article
with respect to their purchases and sales of and reimbursements for
drugs furnished to recipients of medical assistance under this
article. Adjustment rebates shall be made by the successfully
bidding drug manufacturer to the department and be paid quarterly to
the department. (e) In the event no acceptable bids are received for a drug for
which a request for bid was made, the department may select a single
drug supplier for the drug or establish one price for such drug
which the department will reimburse therefor, but this shall not
restrict the department from establishing one price for any drug
upon which the department does not request bids. (f) Except when in conflict with this Code section, Article 3 of Chapter 5 of Title 50, relating to state purchases by the Department of Administrative Services, shall apply to bidding and purchasing of prescription drugs by the department pursuant to this Code section. The prohibitions against financial interest in Code Section 50-5-78 shall be applicable to the commissioner and other employees of the department and any violation thereof punishable as provided in subsection (d) of that Code section. Contracts for the purchase of prescription drugs made in violation of this Code section shall be void and of no effect and liability therefor shall be the same as that provided in Code Section 50-5-79. (g) The department is authorized to accept rebates from any drug
manufacturer for providing information to that manufacturer
regarding utilization by Medicaid recipients of that manufacturer's
drugs as long as the anonymity of the recipients is maintained. The
department is further authorized to verify and audit claims for
reimbursement for drugs successfully bid, provide the manufacturers
thereof with the information so obtained, and to adjust the
department's claim for rebates based upon that information. (h) The provisions of this Code section shall be construed in conformity with Code Section 49-4-157. |