Bill Text: CA SB1264 | 2017-2018 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

---

Bill Title: Medi-Cal: hypertension medication management services.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Engrossed - Dead) 2018-08-16 - August 16 hearing: Held in committee and under submission. [SB1264 Detail]

Download: California-2017-SB1264-Amended.html

---

Amended  IN  Senate  April 12, 2018

Amended  IN  Senate  March 21, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill

No. 1264

---

Introduced by Senator Stone

February 15, 2018

---

An act to amend Section 4052.6 of the Business and Professions Code, and to amend Section 14132.968 of the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL'S DIGEST

SB 1264, as amended, Stone. Medi-Cal: hypertension medication management services: advanced practice pharmacists. services.

Existing law establishes the Medi-Cal program, administered by the State Department of Health Care Services, under which qualified low-income persons receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program program provisions. Existing law provides for a schedule of benefits under the Medi-Cal program, which includes pharmacist services, subject to approval by the federal Centers for Medicare and Medicaid Services. Under existing law, covered pharmacist services include, but are not limited to, furnishing travel medications, initiating and administering immunizations, and providing tobacco cessation counseling counseling, and furnishing nicotine replacement therapy.

Existing law, the Pharmacy Law, provides for the licensure and regulation of pharmacists by the California State Board of Pharmacy. Existing law authorizes a pharmacist recognized by the board as an advanced practice pharmacist to perform specified tasks, including initiating, adjusting, or discontinuing drug therapy in a specified manner.

This bill would additionally authorize an advanced practice pharmacist to provide hypertension medication management services, as defined, to Medi-Cal beneficiaries. The bill would authorize a pharmacist providing hypertension medication management services to access the state health information exchange and any relevant continuity of care documents maintained by a health facility, subject to applicable federal and state privacy and confidentiality laws. This bill would include hypertension medication management services as a covered pharmacist service under the Medi-Cal program.

Digest Key

Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

---

Bill Text

The people of the State of California do enact as follows:

SECTION 1.Section 4052.6 of the Business and Professions Code is amended to read:

4052.6.

(a)A pharmacist recognized by the board as an advanced practice pharmacist may do all of the following:

(1)Perform patient assessments.

(2)Order and interpret drug therapy-related tests.

(3)Refer patients to other health care providers.

(4)Participate in the evaluation and management of diseases and health conditions in collaboration with other health care providers.

(5)Initiate, adjust, or discontinue drug therapy in the manner specified in paragraph (4) of subdivision (a) of Section 4052.2.

(6)Provide hypertension medication management services. For purposes of this section, “hypertension medication management services” means the furnishing of antihypertensive and related medications to Medi-Cal beneficiaries, as authorized by Section 14132.968 of the Welfare and Institutions Code, pursuant to a hypertension diagnosis by a health care practitioner who has prescribing authority and is qualified to make the diagnosis.

(b)A pharmacist who adjusts or discontinues drug therapy shall promptly transmit written notification to the patient’s diagnosing prescriber or enter the appropriate information in a patient record system shared with the prescriber, as permitted by that prescriber. A pharmacist who initiates drug therapy shall promptly transmit written notification to, or enter the appropriate information into, a patient record system shared with the patient’s primary care provider or diagnosing provider, as permitted by that provider.

(c)This section shall not interfere with a physician’s order to dispense a prescription drug as written, or other order of similar meaning.

(d)Prior to initiating or adjusting a controlled substance therapy pursuant to this section, a pharmacist shall personally register with the federal Drug Enforcement Administration.

(e)A pharmacist who orders and interprets tests pursuant to paragraph (2) of subdivision (a) shall ensure that the ordering of those tests is done in coordination with the patient’s primary care provider or diagnosing prescriber, as appropriate, including promptly transmitting written notification to the patient’s diagnosing prescriber or entering the appropriate information in a patient record system shared with the prescriber, when available and as permitted by that prescriber.

(f)A pharmacist who provides hypertension medication management services to Medi-Cal beneficiaries pursuant to paragraph (6) of subdivision (a) shall be authorized to access the state health information exchange and any relevant continuity of care documents maintained by a health facility, as defined in Section 1250 of the Health and Safety Code, subject to applicable federal and state privacy and confidentiality laws.

SEC. 2.SECTION 1.

 Section 14132.968 of the Welfare and Institutions Code is amended to read:

14132.968.

 (a) (1) Pharmacist services are a benefit under the Medi-Cal program, subject to approval by the federal Centers for Medicare and Medicaid Services.

(2) The department shall establish a fee schedule for the list of pharmacist services.

(3) The rate of reimbursement for pharmacist services shall be at 85 percent of the fee schedule for physician services under the Medi-Cal program.

(b) (1) The following services are covered pharmacist services that may be provided to a Medi-Cal beneficiary:

(A) Furnishing travel medications as authorized in clause (3) of subparagraph (A) of paragraph (10) of subdivision (a) of Section 4052 of the Business and Professions Code.

(B) Furnishing naloxone hydrochloride as authorized in Section 4052.01 of the Business and Professions Code.

(C) Furnishing self-administered hormonal contraception, as authorized in Section 4052.3 of the Business and Professions Code.

(D) Initiating and administering immunizations as authorized in Section 4052.8 of the Business and Professions Code.

(E) Providing tobacco cessation counseling and furnishing nicotine replacement therapy as authorized in Section 4052.9 of the Business and Professions Code.

(F) Providing hypertension medication management services pursuant to Section Sections 4052.1, 4052.2, and 4052.6 of the Business and Professions Code.

(2) Covered pharmacist services shall be subject to department protocols and utilization controls.

(c) A pharmacist shall be enrolled as an ordering, referring, and prescribing provider under the Medi-Cal program prior to rendering a pharmacist service that is submitted by a Medi-Cal pharmacy provider for reimbursement pursuant to this section.

(d) (1) The director shall seek any necessary federal approvals to implement this section. This section shall not be implemented until the necessary federal approvals are obtained and shall be implemented only to the extent that federal financial participation is available.

(2) This section does not restrict or prohibit any services currently provided by pharmacists as authorized by law, including, but not limited to, this chapter, or the Medicaid state plan.

(e) Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section, and any applicable federal waivers and state plan amendments, by means of all-county letters, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action. By July 1, 2021, the department shall adopt regulations in accordance with the requirements of Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code. Commencing July 1, 2017, the department shall provide a status report to the Legislature on a semiannual basis, in compliance with Section 9795 of the Government Code, until regulations have been adopted.