Montana Code Annotated 2019

TITLE 53. SOCIAL SERVICES AND INSTITUTIONS

CHAPTER 6. HEALTH CARE SERVICES

Part 10. Prescription Drug Plus Discount Program

Specifications For Administration Of Program

53-6-1010. Specifications for administration of program. (1) The department shall adopt specifications for the administration and management of the program. Specifications may include but are not limited to program objectives, accounting and handling practices, supervisory authority, and an evaluation methodology.

(2) Information disclosed by manufacturers during negotiations and all terms and conditions negotiated between the director and manufacturers and all information requested or required under the program are public information, except for information that the department determines is proprietary information.

(3) The department may use a formulary or other committee to determine preferred drug lists for department programs. The department shall include a representative of consumers on any formulary committee or committee to determine preferred drug lists for purchase by the department or reimbursement of costs. Any formulary or preferred drug list must be based on objective clinical data on safety and effectiveness. If two or more drugs are found to be equally effective and safe for the treatment of the same medical condition, the drug available at the lowest net price, inclusive of discounts and rebates, must be placed on the list. Other drugs for treating the same medical condition may be added to the list if they are therapeutically equivalent and the department determines them to be cost-effective.

(4) The department may negotiate rebates from the prescription drug manufacturers for drugs that will be on any preferred drug list. The department may negotiate price discounts with prescription drug manufacturers for any state-purchased health care programs, including medicaid, the state children's health insurance program, and the program provided for in 53-6-1002.

(5) The department may use the access restrictions and a preferred drug list to negotiate for the most favorable discount prices and rebates for the program.

(6) The department may participate in multistate purchasing pool initiatives for the benefit of the program.

History: En. Sec. 4, Ch. 551, L. 2003; amd. Sec. 7, Ch. 287, L. 2005.