H2212B3642A07460 BIL:BTW 06/11/18 #90 A07460
AMENDMENTS TO HOUSE BILL NO. 2212
Sponsor: REPRESENTATIVE WARD
Printer's No. 3642
Amend Bill, page 1, line 16, by striking out "association"
and inserting
organization
Amend Bill, page 2, line 10, by inserting after "shall"
upon request
Amend Bill, page 2, by inserting between lines 27 and 28
"Pharmacy benefits management." Any of the following:
(1) Procurement of prescription drugs at a negotiated
contracted rate for distribution within this Commonwealth to
covered individuals.
(2) Administration or management of prescription drug
benefits provided by a covered entity for the benefit of
covered individuals.
(3) Administration of pharmacy benefits, including:
(i) Operating a mail-service pharmacy.
(ii) Claims processing.
(iii) Managing a retail pharmacy network management.
(iv) Paying claims to pharmacies for prescription
drugs dispensed to covered individuals via retail or
mail-order pharmacy.
(v) Developing and managing a clinical formulary,
utilization management and quality assurance programs.
(vi) Rebate contracting and administration.
(vii) Managing a patient compliance, therapeutic
intervention and generic substitution program.
(viii) Operating a disease management program.
(ix) Setting pharmacy reimbursement pricing and
methodologies, including maximum allowable cost, and
determining single or multiple source drugs.
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