Today's Law As Amended


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SB-1285 Health care coverage: advanced practice pharmacist.(2017-2018)



As Amends the Law Today


SECTION 1.

 Section 1367.44 is added to the Health and Safety Code, to read:

1367.44.
 (a) Every health care service plan contract that is issued, amended, or renewed on or after January 1, 2019, shall provide coverage for services provided by an advanced practice pharmacist, as defined in Section 4016.5 of the Business and Professions Code, performed within the scope of his or her practice, including, but not limited to, comprehensive medication management (CMM) services.
(b) For purposes of this section, “comprehensive medication management” means the process of care that ensures each beneficiary’s medications, whether they are prescription drugs and biologics, over-the-counter medication, or nutritional supplements, are individually assessed to determine that each medication is appropriate for the beneficiary, effective for the medical condition, and safe given the comorbidities and other medications being taken, and that all medications are able to be taken by the patient as intended.
(c) This section does not apply to a contract with a pharmacy benefit management company or a direct contract for only prescription dispensing or related services.

SEC. 2.

 Section 10123.204 is added to the Insurance Code, to read:

10123.204.
 (a) Every health insurance policy that is issued, amended, or renewed on or after January 1, 2019, shall provide coverage for services provided by an advanced practice pharmacist, as defined in Section 4016.5 of the Business and Professions Code, performed within the scope of his or her practice, including, but not limited to, comprehensive medication management (CMM) services.
(b) For purposes of this section, “comprehensive medication management” means the process of care that ensures each beneficiary’s medications, whether they are prescription drugs and biologics, over-the-counter medication, or nutritional supplements, are individually assessed to determine that each medication is appropriate for the beneficiary, effective for the medical condition, and safe given the comorbidities and other medications being taken, and that all medications are able to be taken by the patient as intended.
(c) This section does not apply to a contract with a pharmacy benefit management company or a direct contract for only prescription dispensing or related services.

SEC. 3.

 Section 14132.09 is added to the Welfare and Institutions Code, to read:

14132.09.
 (a) Services provided by an advanced practice pharmacist, as defined in Section 4016.5 of the Business and Professions Code, performed within the scope of his or her practice, including, but not limited to, comprehensive medication management (CMM) services, shall be a covered benefit in a Medi-Cal managed care plan.
(b) For purposes of this section, “comprehensive medication management” means the process of care that ensures each beneficiary’s medications, whether they are prescription drugs and biologics, over-the-counter medication, or nutritional supplements, are individually assessed to determine that each medication is appropriate for the beneficiary, effective for the medical condition, and safe given the comorbidities and other medications being taken, and that all medications are able to be taken by the patient as intended.
(c) This section does not apply to a contract with pharmacy benefit management companies or a direct contract for only prescription dispensing or related services.
(d) This section shall be implemented only to the extent that federal financial participation is available.
SEC. 4.
 No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.