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                                                      PRINTER'S NO. 3255

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 2251 Session of 2008


        INTRODUCED BY DeLUCA, McILHATTAN, THOMAS, GINGRICH, MUNDY,
           BIANCUCCI, CALTAGIRONE, CASORIO, COHEN, CURRY, DePASQUALE,
           DERMODY, EACHUS, FABRIZIO, FRANKEL, FREEMAN, GALLOWAY,
           GEORGE, GIBBONS, GOODMAN, GRUCELA, HARKINS, HENNESSEY,
           JOSEPHS, KOTIK, LONGIETTI, MANDERINO, MARKOSEK, McGEEHAN,
           MELIO, MILNE, M. O'BRIEN, PASHINSKI, PETRARCA, PETRONE, PYLE,
           READSHAW, REED, REICHLEY, SURRA, WALKO, WANSACZ, J. WHITE,
           YOUNGBLOOD AND YUDICHAK, FEBRUARY 14, 2008

        REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 14, 2008

                                     AN ACT

     1  Establishing One Pennsylvania, a program to consolidate and
     2     unify procedures and requirements for the administration of
     3     all Commonwealth-funded, Commonwealth-administered and
     4     Commonwealth-supported prescription drug programs and for
     5     reimbursement for pharmaceutical services.

     6     The General Assembly of the Commonwealth of Pennsylvania
     7  hereby enacts as follows:
     8  Section 1.  Short title.
     9     This act shall be known and may be cited as the One
    10  Pennsylvania Act.
    11  Section 2.  Definitions.
    12     The following words and phrases when used in this act shall
    13  have the meanings given to them in this section unless the
    14  context clearly indicates otherwise:
    15     "Adjudication."
    16         (1)  Except as provided in paragraph (2), an action taken


     1     by the Office of Administration, the Secretary of
     2     Administration or a prescription drug plan pursuant to this
     3     act that constitutes an adjudication as defined by 2 Pa.C.S.
     4     § 101 (relating to definitions), including any of the
     5     following:
     6             (i)  A decision to allow a provider to participate in
     7         a prescription drug plan or to suspend, restrict or
     8         revoke participation by a provider in a prescription drug
     9         plan.
    10             (ii)  A decision by the Office of Administration to
    11         include or exclude a medication from the formulary or
    12         preferred drug list.
    13             (iii)  The establishment of provider reimbursement
    14         rates and formulas.
    15             (iv)  A decision to grant or deny prior authorization
    16         for the dispensing of prescription drugs or to approve or
    17         disapprove the dispensing of drugs not included on the
    18         formulary or preferred drug list.
    19             (v)  An action taken by the program based upon audits
    20         of claims submitted for reimbursement by providers.
    21         (2)  An action taken by the program with respect to
    22     determining recipient eligibility shall not be deemed an
    23     adjudication by the Office of Administration pursuant to its
    24     authority under this act. Eligibility shall be determined by
    25     the agency or entity under whose authority the prescription
    26     drug plan is authorized.
    27     "Alerts."  Electronic communications between the Office of
    28  Administration or the pharmacy benefits consolidation program
    29  and pharmacies providing information pertaining to the
    30  implementation of this act, including any of the following:
    20080H2251B3255                  - 2 -     

     1         (1)  Information regarding the preferred drug lists.
     2         (2)  Preferred drug lists.
     3         (3)  Drug utilization review.
     4         (4)  Prior authorization.
     5         (5)  Disease management programs.
     6         (6)  Claims submission and adjudication procedures.
     7         (7)  Audits.
     8         (8)  Pharmacy and patient education.
     9     "Best price."  As defined under section 1927(c) of the Social
    10  Security Act (49 Stat. 620, 42 U.S.C. § 1396r-8(c)).
    11     "Medical assistance program."  The program established
    12  pursuant to Subarticle (f) of Article IV of the act of June 13,
    13  1967 (P.L.31, No.21), known as the Public Welfare Code.
    14     "Medicare recipient."  An individual residing in this
    15  Commonwealth who receives benefits under Part A of Subchapter
    16  XVIII of Chapter 7 of the Social Security Act (49 Stat. 620, 42
    17  U.S.C. § 301 et seq.) or who is enrolled under Part B, C or D of
    18  Subchapter XVIII.
    19     "Office of Administration."  The Office of Administration of
    20  the Commonwealth.
    21     "Pharmaceutical manufacturer."  A manufacturer as defined by
    22  section 1927(k)(5) of the Social Security Act (49 Stat. 620, 42
    23  U.S.C. § 1396r-8(k)(5)).
    24     "Pharmacy."  A pharmacy licensed pursuant to the act of
    25  September 27, 1961 (P.L.1700, No.699), known as the Pharmacy
    26  Act.
    27     "Pharmacy Act."  The act of September 27, 1961 (P.L.1700,
    28  No.699), known as the Pharmacy Act.
    29     "Pharmacy services."  The provision of health care services
    30  defined as the practice of pharmacy by the act of September 27,
    20080H2251B3255                  - 3 -     

     1  1961 (P.L.1700, No.699), known as the Pharmacy Act.
     2     "Preferred drug list."  A list of prescription medications
     3  covered under a prescription drug plan that may be dispensed by
     4  a prescription drug plan without prior authorization, subject to
     5  applicable limits and conditions.
     6     "Prescription drug."  A covered outpatient drug as defined by
     7  section 1927(k)(2) of the Social Security Act (49 Stat. 620, 42
     8  U.S.C. § 1396r-8(k)(2)).
     9     "Prescription drug plan."  A Commonwealth operation or funded
    10  pharmaceutical program that pays or reimburses for prescription
    11  drugs dispensed to individuals enrolled in the program that is
    12  supported directly or indirectly, in whole or in part, by
    13  Commonwealth public funds, including, but not limited to, all of
    14  the following:
    15         (1)  The medical assistance program, the Special
    16     Pharmaceutical Benefit Program in the Department of Public
    17     Welfare.
    18         (2)  The Pharmaceutical Assistance Contract for the
    19     Elderly (PACE) and any other pharmacy program administered by
    20     the Commonwealth that is recognized by the Centers for
    21     Medicare and Medicaid of the United States as a State
    22     pharmaceutical assistance program.
    23         (3)  Programs or plans paying for prescription drugs
    24     dispensed to employees as a retirement or employee benefit,
    25     including programs established by the Public School
    26     Employees' Retirement System, the State Employees' Retirement
    27     System and the State Employees' Benefit Trust Fund.
    28         (4)  A pharmaceutical program that utilizes funds of this
    29     Commonwealth, including the State Lottery Fund, to provide
    30     assistance in obtaining prescription drugs to Medicare
    20080H2251B3255                  - 4 -     

     1     recipients.
     2         (5)  Programs where the Commonwealth purchases or
     3     reimburses affiliates or designees for a pharmaceutical drug
     4     benefit. The programs shall include the Children's Health
     5     Insurance Program, Workers' Compensation Program and any
     6     program involving the purchase or reimbursement of
     7     pharmaceutical drugs for inmates under the Department of
     8     Corrections.
     9         (6)  The End Stage Renal Program in the Department of
    10     Health.
    11         (7)  All prescription drug plans that prescribe benefits
    12     to members and employees of the General Assembly and the
    13     unified judicial system and its retirees.
    14     "Program."  The One Pennsylvania pharmacy benefits
    15  consolidation program established pursuant to section 3.
    16     "Provider."  A pharmacy, a dispensing physician or a
    17  certified registered nurse practitioner enrolled as a provider
    18  in the One Pennsylvania program.
    19     "Public School Employees' Retirement System."  The retirement
    20  system established by 24 Pa.C.S. Part IV (relating to retirement
    21  for school employees).
    22     "Public Welfare Code."  The act of June 13, 1967 (P.L.31,
    23  No.21), known as the Public Welfare Code.
    24     "Retail pharmacy."  A pharmacy licensed to operate pursuant
    25  to the act of September 27, 1961 (P.L.1700, No.699), known as
    26  the Pharmacy Act, which provides services to the general public,
    27  excluding any institutional pharmacy, specialty pharmacy or
    28  mail-order pharmacy.
    29     "Secretary."  The Secretary of Administration of the
    30  Commonwealth.
    20080H2251B3255                  - 5 -     

     1     "Social Security Act."  The Social Security Act (49 Stat.
     2  620, 42 U.S.C. § 301 et seq.). A reference to the Social
     3  Security Act shall include regulations implementing the Social
     4  Security Act adopted by the United States Department of Health
     5  and Human Services or the Centers for Medicare and Medicaid
     6  Services.
     7     "State agency."  Any of the following entities that purchases
     8  or provides coverage for prescription medications:
     9         (1)  An agency under the jurisdiction of the Governor.
    10         (2)  An independent agency supported by public funds.
    11     "State Employees' Benefit Trust Fund."  The trust fund
    12  established to purchase health insurance coverage, including
    13  coverage for prescription medications, for State employees.
    14     "State Employees' Retirement System."  The retirement system
    15  established under 71 Pa.C.S. Part XXV (relating to retirement
    16  for State employees and officers).
    17  Section 3.  One Pennsylvania.
    18     (a)  Establishment.--The Office of Administration shall
    19  establish a pharmacy benefits consolidation program to be known
    20  as One Pennsylvania. The program shall administer all publicly
    21  funded Commonwealth prescription drug plans through an
    22  integrated system of plan administration using uniform standards
    23  and requirements for the reimbursement to providers as provided
    24  by this act.
    25     (b)  Program requirements.--The Office of Administration
    26  shall do all of the following:
    27         (1)  Develop, manage and implement preferred drug lists
    28     for all publicly funded Commonwealth prescription drug plans
    29     to the extent allowed by applicable Federal law. A preferred
    30     drug list shall include all prescription drugs for which a
    20080H2251B3255                  - 6 -     

     1     manufacturer has entered into a rebate agreement pursuant to
     2     section 6 and the requirements and restrictions, except for
     3     prior authorization, provided by section 1927(d) of the
     4     Social Security Act. A preferred drug list shall comply with
     5     the standards established by Part D, section 1860D-4(b)(3) of
     6     the Social Security Act and any additional regulations as may
     7     be adopted by the Office of Administration pursuant to this
     8     act. A current list of drugs included in the preferred drug
     9     list shall be publicly available, posted electronically on
    10     the Internet website of the Office of Administration and
    11     communicated to pharmacies through alerts. All preferred drug
    12     lists shall be uniform to the extent administratively
    13     feasible under the statutory authority establishing the
    14     individual prescription drug plans. The Office of
    15     Administration may, in its discretion, allow exceptions to
    16     the uniformity requirements in administrating the individual
    17     programs due to fiscal and administrative considerations.
    18         (2)  Adopt regulations relating to the eligibility of
    19     participating providers and the adjudication of items and all
    20     other provisions necessary to carry out the provisions of
    21     this act. Any pharmacy shall be eligible to participate in
    22     the program, provided the pharmacy complies with the
    23     regulations adopted under the paragraph and other provisions
    24     of this act.
    25         (3)  The Office of Administration shall promulgate
    26     statements of policy, as necessary, to carry out the
    27     provisions of this act. No statement of this policy adopted
    28     by the Office of Administration shall have the force and
    29     effect of law or regulation or may modify the provisions of
    30     any regulations adopted by the Office of Administration. All
    20080H2251B3255                  - 7 -     

     1     statements of policy adopted by the Office of Administration
     2     shall, except in emergency circumstances, be published for
     3     notice and comment prior to adoption and shall be published
     4     in the Pennsylvania Bulletin.
     5         (4)  (i)  Except as provided in subparagraph (ii), make
     6         provisions for generic substitutions in accordance with
     7         the act of November 24, 1976 (P.L.1163, No.259), referred
     8         to as the Generic Equivalent Drug Law.
     9             (ii)  Notwithstanding the provisions of the Generic
    10         Equivalent Drug Law and the act of August 26, 1971
    11         (P.L.351, No.91), known as the State Lottery Law, generic
    12         substitutions shall only be dispensed when it is less
    13         expensive for the program.
    14         (5)  Provide for a program of prospective drug
    15     utilization review consistent with section 1927(g)(2) of the
    16     Social Security Act.
    17         (6)  Provide for prior authorization consistent with the
    18     requirements of section 1927(g)(5)of the Social Security Act
    19     and in accordance with regulations of the Office of
    20     Administration.
    21         (7)  Provide for a program of retrospective drug
    22     utilization review and education consistent with section
    23     1927(g)(2) of the Social Security Act and in accordance with
    24     regulations of the Office of Administration to ensure that
    25     prescriptions are appropriate, medically necessary and not
    26     likely to result in adverse medical results and to educate
    27     providers and recipients of pharmacy services through the
    28     pharmacy consolidated benefits program and to correct and
    29     report misutilization and abuse by licensed prescribers and
    30     recipients and provide for fraud and abuse audits,
    20080H2251B3255                  - 8 -     

     1     coordinating its activities with the secretary to support
     2     compliance with applicable laws and regulations. Pharmacies
     3     shall not be denied payments for medications dispensed based
     4     upon the results of retrospective drug utilization review or
     5     audits, where the medication was dispensed in good faith by
     6     the pharmacy without prior knowledge that the prescription of
     7     a medication was not appropriate or necessary, was likely to
     8     cause adverse medical results or constituted a fraudulent or
     9     abusive practice by the prescriber.
    10         (8)  Establish a program of medication therapy management
    11     consistent with section 1860D-4(c)(2) of the Social Security
    12     Act.
    13         (9)  Provide educational materials for program recipients
    14     of pharmacy services on disease and care management.
    15         (10)  In accordance with section 1927(a) through (d) of
    16     the Social Security Act or Chapter 7 of the act of August 26,
    17     1971 (P.L.351, No.91), known as the State Lottery Law, bill,
    18     recoup and relay to the medical assistance program
    19     manufacturers' drug rebates and excessive consumer price
    20     inflation discounts and resolve disputes. Upon the
    21     establishment of the program, all medical assistance
    22     recipients shall be enrolled in prescription drug programs
    23     for which rebates and discounts are collected pursuant to
    24     section 1927(a) through (d) of the Social Security Act.
    25         (11)  Adjudicate claims through an electronic claims
    26     management system consistent with section 1927(h) of the
    27     Social Security Act and which allows for an emergency supply
    28     of prescribed medication in the event of equipment failures.
    29         (12)  The Office of Administration shall develop a manual
    30     setting forth procedures, guidelines and standards to be
    20080H2251B3255                  - 9 -     

     1     utilized by prescription drug plans in audits of providers
     2     pertaining to the program.
     3         (13)  Create a uniform audit and recoupment system
     4     subject to the requirements of section 7(c) for all of the
     5     following:
     6             (i)  Pharmacies, pharmacists, dispensing physicians
     7         and any other providers under this act.
     8             (ii)  Pharmaceutical manufacturers, wholesalers and
     9         other suppliers of prescription drugs.
    10         (14)  Provide for the reimbursement of all providers
    11     participating in prescription drug programs on a fee-for-
    12     service basis.
    13         (15)  Allow providers certified in medication therapy
    14     management by a national accrediting body or by any other
    15     certification process approved by the State Board of Pharmacy
    16     to provide medication therapy management.
    17     (c)  Considerations.--In preparing and managing the uniform
    18  drug list, the Office of Administration shall enter into
    19  agreements with drug manufacturers to collect and remit to the
    20  program discounts, rebates or other concessions offered by
    21  manufacturers.
    22     (d)  Advisory committee.--
    23         (1)  An advisory committee for One Pennsylvania is
    24     established to assist the program in making informed and
    25     fiscally responsive decisions in administering and
    26     consolidating the purchases and reimbursements of
    27     pharmaceutical drugs and benefits for the Commonwealth.
    28         (2)  An advisory committee to the Office of
    29     Administration shall consist of the following members:
    30             (i)  Three members appointed by the Governor.
    20080H2251B3255                 - 10 -     

     1             (ii)  Two members appointed by each of the following:
     2                 (A)  The President pro tempore of the Senate.
     3                 (B)  The Minority Leader of the Senate.
     4                 (C)  The Speaker of the House of Representatives.
     5                 (D)  The Minority Leader of the House of
     6             Representatives.
     7         (3)  Each legislative appointing authority shall appoint
     8     one member pursuant to paragraph (1)(ii) involved in the
     9     ownership or operation of independent pharmacies and one
    10     member involved in the ownership or operation of chain
    11     pharmacies.
    12         (4)  Members of the committee shall serve without
    13     compensation but shall be reimbursed for their reasonable and
    14     necessary expenses by the Office of Administration.
    15         (5)  Members of the committee shall serve for indefinite
    16     terms at the will of their respective appointing authorities.
    17         (6)  Action by the committee shall require a vote by at
    18     least seven members.
    19         (7)  Members of the committee shall annually elect a
    20     chairperson.
    21         (8)  The advisory committee shall meet twice yearly to
    22     provide advice and recommendations to the program in regard
    23     to its policies and regulations. The advisory committee shall
    24     review the audit manual and rebate agreement yearly and
    25     develop recommendations to the Office of Administration as
    26     needed.
    27  Section 4.  Reimbursement.
    28     (a)  General rule.--Reimbursement to providers shall include
    29  all of the following:
    30         (1)  Payment sufficient to reimburse retail pharmacies
    20080H2251B3255                 - 11 -     

     1     for the reasonable and necessary costs incurred to purchase
     2     drugs.
     3         (2)  Except to the extent otherwise required by Federal
     4     law or regulations, payments to retail pharmacies pursuant to
     5     paragraph (1) shall be based upon the average retail pharmacy
     6     acquisition cost for a medication without regard to customary
     7     prompt pay discounts in the package size most commonly
     8     purchased by retail pharmacies as determined by the Office of
     9     Administration pursuant to subsection (d), or a provider's
    10     actual acquisition cost for a medication, whichever amount is
    11     greater.
    12         (3)  Payment for dispensing costs adequate to cover costs
    13     associated with all of the following:
    14             (i)  Wages and salaries.
    15             (ii)  Costs to store and secure inventory.
    16             (iii)  Patient counseling.
    17             (iv)  Drug utilization review.
    18             (v)  Licensing fees.
    19             (vi)  Taxes.
    20             (vii)  Insurance.
    21             (viii)  Other direct and indirect costs of operating
    22         a pharmacy.
    23             (ix)  A reasonable profit to generate a return on the
    24         investment associated with the costs.
    25         (4)  During the first year this section is in effect,
    26     payments pursuant to paragraph (3) shall be not less than $10
    27     for the dispensing of a single source drug as defined by
    28     section 1927(k)(7)(A)(iv) of the Social Security Act or $15
    29     for the dispensing of a multiple-source drug as defined by
    30     section 1927(k)(7)(A)(iv) of the Social Security Act.
    20080H2251B3255                 - 12 -     

     1     Beginning on January 1 of each subsequent year, payment
     2     pursuant to paragraph (3) shall be not less than the prior
     3     year's minimum payments as adjusted based upon the annual
     4     percentage change in Consumer Price Index for medical care
     5     professional services as published by the Bureau of Labor
     6     Statistics of the United States Department of Labor for the
     7     month of December of the immediately prior year.
     8         (5)  Additional payment for:
     9             (i)  Medication therapy management.
    10             (ii)  Concurrent and retrospective utilization
    11         review.
    12             (iii)  Managing prior authorization requirements.
    13             (iv)  To the extent authorized by section 9.1 of the
    14         Pharmacy Act, implementing drug therapy protocols.
    15             (v)  Compounding prescriptions.
    16             (vi)  Preparing specialized packaging for the
    17         administration of medications in long-term care
    18         facilities.
    19             (vii)  Preparing medications for intravenous
    20         administration.
    21             (viii)  Other reasonable and necessary pharmacy
    22         services.
    23     (b)  Prompt payment.--Providers shall be paid within 21 days
    24  of the Office of Administration's receipt of appropriate
    25  substantiation of the transaction. Providers shall be entitled
    26  to interest at the rate provided by section 806 of the act of
    27  April 9, 1929 (P.L.343, No.176), known as The Fiscal Code, for
    28  any payment not made within the 21-day period.
    29     (c)  Average retail pharmacy acquisition costs.--The Office
    30  of Administration shall determine and publicly make available
    20080H2251B3255                 - 13 -     

     1  through its Internet website the average retail pharmacy
     2  acquisition cost for covered medications pursuant to regulations
     3  approved by the advisory committee in a manner consistent with
     4  the methodology used by the Congressional Budget Office in its
     5  December 26, 2006, report to the Committee on Energy and
     6  Commerce of the United States House of Representatives based
     7  upon a survey of retail pharmacy wholesale invoices or through
     8  the use of commercially available sources of information.
     9  Average pharmacy acquisition costs shall be updated weekly.
    10     (d)  Copayments.--Except for services which are excluded
    11  under the Commonwealth's medical assistance program, the Office
    12  of Administration may require providers to collect a copayment
    13  in an amount set by the program. To the extent a provider is
    14  required by Federal or State law to dispense prescriptions to
    15  persons unable to satisfy copayment obligations, the provider
    16  shall be reimbursed for uncollected copayment amounts. The
    17  Office of Administration shall neither require copayments from
    18  beneficiaries nor deduct copayment amounts from provider
    19  reimbursements for any particular classes of drugs or
    20  prescription drug plan recipients to the extent there is good
    21  cause to conclude that copayment requirements will result in
    22  noncompliance with prescription drug treatment protocols and
    23  will increase overall health care costs or result in imminent
    24  and substantial risk of harm or injury to recipients or other
    25  persons. Except to the extent prohibited by Federal law, the
    26  Office of Administration may accept compensation for the purpose
    27  of reducing or eliminating copayments from drug manufacturers,
    28  distributors, health care plans or other persons or
    29  organizations for the purpose of encouraging therapeutically
    30  desirable compliance with prescription drug treatment protocols.
    20080H2251B3255                 - 14 -     

     1  Section 5.  Deposit of funds.
     2     A special fund is established in the State Treasury to be
     3  known as the Special Pharmaceutical Fund. All moneys
     4  appropriated from the State Lottery Fund for PACE operations
     5  shall be deposited in the Special Pharmaceutical Fund. All
     6  Federal moneys received by the Commonwealth per any
     7  pharmaceutical program consolidated into One Pennsylvania under
     8  this act shall be deposited in the Special Pharmaceutical Fund.
     9  Any moneys appropriated from the General Fund for pharmaceutical
    10  purchasing or reimbursement shall be deposited in this fund. All
    11  rebates obtained through prudent pharmaceutical purchasing or
    12  through rebate agreements shall be deposited.
    13  Section 6.  Rebate agreement.
    14     (a)  Required agreements.--Except as provided in subsection
    15  (b), the Office of Administration shall not include on the
    16  formulary of preferred drug list established pursuant to section
    17  3(b)(1) any prescription drug unless the Office of
    18  Administration and the pharmaceutical manufacturer have entered
    19  into a rebate agreement covering that prescription drug on terms
    20  comparable to agreements executed pursuant to section 1927(a),
    21  (b), (c) and (d) of the Social Security Act. The rebate
    22  agreement shall provide that, unless prohibited by Federal law,
    23  the rebate shall be based on the best price and that additional
    24  rebates shall be paid if the pharmaceutical manufacturer
    25  increases the price of the drug by an amount greater than the
    26  increase in the Consumer Price Index for All Urban Consumers.
    27  Nothing in this act shall prevent the Office of Administration
    28  from negotiating agreements for the payment of additional
    29  rebates and discounts for the benefit of the medical assistance
    30  program or from entering into rebate and discount agreements for
    20080H2251B3255                 - 15 -     

     1  other plans which have been consolidated into the program for
     2  greater rebates and discounts than are required pursuant to
     3  section 1927(c) of the Social Security Act.
     4     (b)  Exceptions.--Subsection (a) shall not apply if the
     5  availability of the drug is essential to the health of members
     6  of the pharmacy consolidated benefits program as determined by
     7  the department.
     8     (c)  Contracts.--Pharmaceutical manufacturers must enter into
     9  a rebate agreement with the department to obtain reimbursement
    10  for prescription drugs included under this act. The rebate shall
    11  be paid by the manufacturer not later than 30 days after the
    12  date of receipt of information necessary to calculate the amount
    13  of the rebate. The department shall have the authority to levy a
    14  15% surcharge penalty on any rebate not in dispute that remains
    15  unpaid for 90 or more days.
    16  Section 7.  Adjudications.
    17     Adjudications conducted by the Office of Administration shall
    18  be subject to 2 Pa.C.S. Ch. 5 Subch. A (relating to practice and
    19  procedure of Commonwealth agencies) and Ch. 7 Subch. A (relating
    20  to judicial review of Commonwealth agency action). The Office of
    21  Administration shall adopt rules of procedure regarding the
    22  conduct of adjudications involving pharmacies consistent with
    23  the provisions of 67 Pa.C.S. §§ 1102 (relating to hearings
    24  before the bureau), 1103 (relating to supersedeas), 1104
    25  (relating to subpoenas) and 1105 (relating to determinations,
    26  review, appeal and enforcement).
    27  Section 8.  Applicability.
    28     This act shall apply to the medical assistance program except
    29  to the extent the secretary, in consultation with the Secretary
    30  of Public Welfare, determines that the application is a
    20080H2251B3255                 - 16 -     

     1  violation of Federal law or an existing contractual agreement.
     2  Nothing in this act shall supersede or impede an existing
     3  contractual agreement. Contractual agreements in effect on the
     4  effective date of this section shall not be renewed or extended
     5  to the extent inconsistent with the requirements of this act,
     6  and the Office of Administration shall promptly enter into
     7  negotiations to modify any contractual agreements inconsistent
     8  with this act to conform to the requirements of this act.
     9  Section 9.  Prohibited activities.
    10     It shall be unlawful for any individual, partnership or
    11  corporation to solicit, receive, offer or pay any kickback,
    12  bribe or rebate in cash or in kind from or to any person in
    13  connection with the furnishing of services under this act to the
    14  same extent as prohibited with respect to Federal health
    15  programs by section 1128(b)(1) and (2) of the Social Security
    16  Act, subject to the safe harbors from sanctions provided by
    17  sections 1877(a)(1) and 1860D-4(e)(6) of the Social Security
    18  Act. Violations of this section shall be subject to the
    19  sanctions, penalties and remedies under section 1407 of the
    20  Public Welfare Code.
    21  Section 10.  Repeals.
    22     (a)  Intent.--The General Assembly declares that the repeal
    23  under subsection (b) is necessary to effectuate the purposes of
    24  this act.
    25     (b)  Provision.--Section 509 of the act of August 26, 1971
    26  (P.L.351, No.91), known as the State Lottery Law, is repealed.
    27     (c)  General.--All other acts and parts of acts are repealed
    28  insofar as they are inconsistent with this act.
    29  Section 11.  Effective date.
    30     This act shall take effect as follows:
    20080H2251B3255                 - 17 -     

     1         (1)  Sections 3(d), 4(a)(4) and 6 shall take effect
     2     immediately.
     3         (2)  The remainder of this act shall take effect in one
     4     year.


















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