House File 767 -H-1160 IntroducedAmend HOUSEHouse FILEFile 767 BYas COMMITTEEfollows: ON HUMAN RESOURCES (SUCCESSOR TO HSB 224) A BILL FOR An Act relating to participating network provider pharmacies and pharmacists under Medicaid managed care.

BE1. IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

TLSBPage 2359HV1, (2)before 89line pf/rh1 H.F.by inserting:

767<Section Section 1.

MEDICAIDNEW MANAGEDSECTION. CARE —— PARTICIPATING PHARMACIES AND PHARMACISTS.

A147.163 MedicaidRestriction managed care organization shall contract with any licensed pharmacy or pharmacist located within the geographic service area of theprescribing managedauthority care organization as a participating network provider if the licensed pharmacy or pharmacist agrees to comply with the terms and conditions for participation in the managed care organization’s network, meets and agrees to the conditions for participation in the Medicaid program established by theboard. department of human services, accepts the prevailing Medicaid reimbursement, and is subject to license discipline pursuant to section 155A.12 or 155A.15, as applicable.

EXPLANATION1. The inclusion of this explanation does not constitute agreement with the explanation’s substance by the members of the general assembly.

ThisAny billboard requirescreated aunder Medicaidthis managedchapter carethat organizationlicenses toa contractprescribing withpractitioner anyshall licensednot pharmacyrestrict or pharmacist located within the geographicprescribing serviceauthority area of thea managedprescribing carepractitioner organizationduring as a participatingpublic networkhealth providerdisaster ifin thea licensedway pharmacythat oracts pharmacistas agreesa todeterrent comply with the terms and conditions for participationa inprescribing thepractitioner managed care organization’s network, meets and agrees to theuse conditionsa formedication participationor treatment in theaccordance Medicaidwith program established by the departmentprescribing ofpractitioner’s humanbest services,professional acceptsjudgment. the prevailing Medicaid reimbursement, and is subject to license discipline.

LSB2. 2359HV (2) 89 -1- pf/rh 1/1

For purposes of this section:

a.

“Prescribing practitioner” means the same as defined in section 147.162.

b.

“Public health disaster” means the same as defined in section 135.140.> 2.

Title page, line 1, after <to> by inserting <pharmacists, pharmacies, and prescribing practitioners including limitations on prescribing authority and> ______________________________ SALMON of Black Hawk ______________________________ JACOBSEN of Pottawattamie ______________________________ CISNEROS of Muscatine HF767.1168 (3) 89 -1- pf/rh 1/1