H1532B2195A09366 DMS:JMT 09/24/18 #90 A09366
AMENDMENTS TO HOUSE BILL NO. 1532
Sponsor: SENATOR BAKER
Printer's No. 2195
Amend Bill, page 1, lines 9 through 12, by striking out all
of said lines and inserting
Section 1. Section 9(b)(7) of the act of October 27, 2014
(P.L.2911, No.191), known as the Achieving Better Care by
Monitoring All Prescriptions Program (ABC-MAP) Act, is amended
and the subsection is amended by adding a paragraph to read:
Amend Bill, page 1, line 19; page 2, lines 1 through 17; by
striking out all of said lines on said pages and inserting
(7) Designated Commonwealth personnel and contracted
staff who are responsible for the development and evaluation
of quality improvement strategies, program integrity
initiatives or conducting internal compliance reviews and
data reporting for the medical assistance program, Children's
Health Insurance Program (CHIP), Pharmaceutical Assistance
Contract for the Elderly (PACE) or Pharmaceutical Assistance
Contract for the Elderly Needs Enhancement Tier (PACENET).
* * *
(12) Personnel of an organization that has an agreement
to be paid on a capitated basis to provide services to
medical assistance beneficiaries, who are engaged in care
management, the development and evaluation of quality
improvement strategies, program integrity initiatives or
conducting internal compliance reviews and data reporting for
the medical assistance program. Personnel engaged in these
activities:
(i) May query the system to review the requested
dispensing or prescribing of a controlled substance under
this act to an individual to whom the organization
provides services under Title XIX of the Social Security
Act.
(ii) Shall notify the Department of Human Services
and the Office of Attorney General if fraud is suspected
based on the results of the query and review of the
database.
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